About Your Office (Required)
Question 1: What are your practice's current reporting capabilities
for OB/GYN ultrasound exams?*
Select one...
Transcription
Manual Notes in File
Commercial Software
Voice Recognition
If commercial software, which
one?
Select one...
None
DMC
BabyScan
Digisonics
ClickView
R4
Babe
Vision Chips
Solomon
Sonultra
Other
Year purchased:
Question 2: How many OB scans does your practice perform
each month?*
Question 3: How many OB images does your practice take per
study?*
Question 4: How many GYN scans does your practice perform
each month?*
Question 5: How many GYN images does your practice take per study
?*
Question 6: What type of ultrasound machine(s) does your
practice have?*
U/S Machine #1:
Select one...
Acuson (XP Series)
Acuson (Sequoia)
Acuson (Aspen)
Aloka (1000)
Aloka (1400, 1700)
Aloka (3500)
Aloka (4000)
Aloka (5000, 5500)
Aloka (Alpha 5)
Aloka (Alpha 10)
Aloka (Other)
GE (Logiq 200 Pro)
GE (Logiq 200 Alpha)
GE (Logiq 400)
GE (Logiq 500)
GE (Logiq 700)
GE (Logiq 3)
GE (Logiq 5)
GE (Logiq 7)
GE (Logiq 9)
GE (LogiqBook)
GE (LogiqbookI)
GE (LogiqbookE)
GE (Voluson-730)
GE (Voluson E6)
GE (Voluson E8)
GE (Other)
Medison (8000)
Medison (9900)
Medison (Accuvix)
Medison (SonoAce X4)
Medison (SonoAce X8)
Medison (V10)
Medison (V20)
Medison (V30)
Medison (Other)
Philips/ATL (1000)
Philips/ATL (3000, 3500)
Philips/ATL (4000)
Philips/ATL (5000)
Philips/ATL (400C)
Philips/ATL (Envisor)
Philips/ATL (HD 3)
Philips/ATL (HD 7)
Philips/ATL (HD 9)
Philips/ATL (HD 11)
Philips/ATL (HD 15)
Philips/ATL (IU22)
Philips/ATL (UM9)
Philips/ATL (UM4)
Philips/ATL (Other)
Siemens (Antares)
Siemens (G 60)
Siemens (G 40)
Siemens (G 20)
Seimens (Elegra)
Siemens (S2000)
Siemens (X150)
Siemens (X300)
Siemens (X500)
Seimens (Other)
SonoSite (Titan)
Toshiba (Aplio)
Toshiba (JustVision)
Toshiba (Nemio)
Toshiba (Xario)
Toshiba (Powervision)
Toshiba (Powervision 380)
Toshiba (Powervision 6000 SSA-370A)
Toshiba (Ecocee)
Toshiba (Nemio 20 SSA-550A)
Toshiba (Other)
ULTRASONIX
Other
U/S Machine #2:
Select one...
Acuson (XP Series)
Acuson (Sequoia)
Acuson (Aspen)
Aloka (1000)
Aloka (1400, 1700)
Aloka (3500)
Aloka (4000)
Aloka (5000, 5500)
Aloka (Alpha 5)
Aloka (Alpha 10)
Aloka (Other)
GE (Logiq 200 Pro)
GE (Logiq 200 Alpha)
GE (Logiq 400)
GE (Logiq 500)
GE (Logiq 700)
GE (Logiq 3)
GE (Logiq 5)
GE (Logiq 7)
GE (Logiq 9)
GE (LogiqBook)
GE (LogiqbookI)
GE (LogiqbookE)
GE (Voluson-730)
GE (Voluson E6)
GE (Voluson E8)
GE (Other)
Medison (8000)
Medison (9900)
Medison (Accuvix)
Medison (SonoAce X4)
Medison (SonoAce X8)
Medison (V10)
Medison (V20)
Medison (V30)
Medison (Other)
Philips/ATL (1000)
Philips/ATL (3000, 3500)
Philips/ATL (4000)
Philips/ATL (5000)
Philips/ATL (400C)
Philips/ATL (Envisor)
Philips/ATL (HD 3)
Philips/ATL (HD 7)
Philips/ATL (HD 9)
Philips/ATL (HD 11)
Philips/ATL (HD 15)
Philips/ATL (IU22)
Philips/ATL (UM9)
Philips/ATL (UM4)
Philips/ATL (Other)
Siemens (Antares)
Siemens (G 60)
Siemens (G 40)
Siemens (G 20)
Seimens (Elegra)
Siemens (S2000)
Siemens (X150)
Siemens (X300)
Siemens (X500)
Seimens (Other)
SonoSite (Titan)
Toshiba (Aplio)
Toshiba (JustVision)
Toshiba (Nemio)
Toshiba (Xario)
Toshiba (Powervision)
Toshiba (Powervision 380)
Toshiba (Powervision 6000 SSA-370A)
Toshiba (Ecocee)
Toshiba (Nemio 20 SSA-550A)
Toshiba (Other)
ULTRASONIX
Other
Question 7: How does your practice generate and store images?*
Select one...
Thermal prints
Video Tape
Thermal Prints & Video
U/S Scanner Opitcal Drive
Digital Storage (DICOM Out)
Digital Storage (Video Out)
Film
Question 8: Has your practice given any consideration to
becoming accredited?*
Select one...
Yes, Already Accredited
Application Pending
Seriously Considering It
Don't know how to Proceed
Don't think its Important
No Consideration
Question 9: Is accreditation affecting how your practice
would purchase an ultrasound machine?*
Select one...
Yes, Significantly
Yes, Just a little
Not at all
Not Sure
Question 10: If an ultrasound reporting system was available
to your practice that conformed with accreditation guidelines,
saved your time and money, improved your clinical information,
and cost less than $1.00 per study, would your practice be interested
in purchasing this system?*
Select one...
Immediately
Within 3 Months
Within 6 Months
Within 1 Year
Not Sure
Question 11: If an office-based, image management system
was available to your practice that conformed with accreditation
guidelines, save you time and money on thermal, prints, and
cost approximately $2.00 per study, would your practice be interested
in purchasing this system?*
Select one...
Immediately
Within 3 Months
Within 6 Months
Within 1 Year
Not Sure
Question 12: Does your practice have plans to purchase an
ultrasound machine?*
Select one...
Immediately
Within 3 Months
Within 6 Months
Within a Year
Within 2 Years
Not Sure
About Yourself (Optional)
Question 1: What are your current job responsibilities?
Select one...
Hospital U/S Department
Private Office Scans
Consulting Service
Mobile Service
Question 2: What is your interest in Sonultra?
Select one...
Part-Time Position
Full-Time Position
Consulting
Product Development
Training
Question 3: What is your experience with our products?
Select one...
Currently using your Reporting System
Have used your Reporting System in the past
Never used your Reporting System
I was referred to you by a Colleague
I have evaluated your Reporting System
Question 4: If your interest is part-time, how many days
per month would you be available?
Select one...
1-2
3-4
5-6
7+
Question 5: Do you have any travel restrictions?
Select one...
Yes, I need to remain local at all times
Yes, I would like to remain within 200 miles of home
No, none at all
Question 7: How would you best describe your computer skills?
Select one...
Excellent, strong knowledge of Windows Programs
Excellent, strong knowledge of Macintosh Programs
Good skills
Average skills
Needs improvement, training
Question 8: Do you currently own a laptop?
Select one...
Yes
No
Planning to purchase
Additional Comments: Please provide
Sonultra with your thoughts, comments and ideas.