Free HHN Mag
hospitalconnect.com
go
               advanced search >>   
  

Health care industry personnel please complete the questions below to receive a FREE subscription.

For non-health care industry personnel, please click here.

*Signifies that an entry is required.

I wish to receive/continue receiving H&HN FREE*     Yes  No
(Note: Please enter your information below. If you would like to order a subscription on behalf of someone else, please include their information at the bottom of this form.)
First Name:*
Last Name:*
Job Title:*
Department:
Company:*
Company Phone:
(Ex: 555-555-5555)
Company Fax:
(Ex: 555-555-5555)
Address:*
City:*
State:*
Zip Code:*
Email:*

Hospital/Nursing Home Personnel (bed count):
# of Beds* (Enter 'N' if unknown.)
 

Please check the one category which best describes your title/business:*

Hospital/Nursing Home Personnel:

01 Administrator 26 CIO 89 Dir Telecommun
02 CEO 19 CMIO/Chief Med Info Officer 24 CMO/Med Dir/Chief Staff
80 COO 07 CPO/Matls Mgr 28 Chief Pharmacist
81 Executive VP 17 Med Recs Admin 29 CNO/Dir Nursing Svc
33 VP/Asst Adm-General 25 Info Syst Mgr 23 Medical Imaging Mgmt
03 VP/Asst Adm Clinical Svc 27 Mgd Care Admin 82 Dir Lab Svc
04 VP/Asst Adm Financial Svc 50 Risk Mgmt/Compl Dir 83 Dir Cardiology
05 VP/Asst Adm Mktg/Plng/PR 75 Qual/Pt Safety Dir 84 Dir OR
06 VP/Asst Adm Operations 76 Patient Relations Dir 85 Dir Emer Room
09 VP/Asst Adm Info Sys 77 Util Review Dir 86 Dir Amb Care
10 VP/Asst Adm Facilities 78 Dir Communications 87 Dir Intensive Care
11 VP/Asst Adm Mgd Care 79 Dir HR 88 Dir Respiratory Care
12 VP/Asst Adm HR 18 Dir Mktg/Plng/ PR 31 Nursing Home Adm
08 CFO 30 Dir Security 49 Chief Accountant
       

52 Other Exec
(Please specify below)

     

Health System Executives:
35 CEO 36 COO 37 CFO
38 CPO/Matls Mgr 39 Dir Mktg/Plng/PR 40 Dir Const/Design
44 Board Mbrs 98 Other
(Please specify below)
   
         

Other Health Care Organization Personnel:
56 HMOs/PPOs/Mgd Care/Insur Firm 73 Consultants 72 Schools/Library
53 Med Clinic/Group Practice 64 State/Govt Org 67 Acctg/Investment/Law Firm
55 Surg/Emer/AmbCtr/Home Hlth 63 Grp Purch Org 71 Allied Hlth Care
66 Benefit Planner/Coalitions 74 Mfg Equip/Svcs 99 Other
(Please specify below)
     

From time to time H&HN and its partners may use the information provided to offer you pertinent industry information.

From time to time Health Forum and its partners may use the information provided on your subscription/renewal to offer you pertinent industry information.
Do you wish to receive this information? * Yes No

H&HN is an audited circulation magazine. In order to verify request with availability of a signature, our auditors require that we ask for one piece of personal information from you. This information is solely for the purpose of audit requirements.

What is the city of your birth? *

 * Please note that the Publisher reserves the right to determine free eligibility.


Additional Subscriptions: Please list below other members of your staff at this location to whom we should send or continue to send a FREE subscription to H&HN.

First Name: Last Name: Job Title:
First Name: Last Name: Job Title:



  



HOME | ABOUT HEALTH FORUM | CONTACT US | AHA HOME | HEALTH FORUM PRESS RELEASES

The views expressed in these websites are those of the sponsoring organization
and do not necessarily reflect the views of the American Hospital Association.