Your browser does not support flash. If you are on a browser that does support flash then please download the latest version of the Adobe Flash Player.




Good Samaritan Hospital

Marketing Survey

Age:

Under 18

18-30

31-45

45-65

65-80

80 and older

Education (please check highest level completed):

Some high school

High School graduate

Some College

Associate's Degree

Bachelor's Degree

Master's Degree

Doctorate

Please list your home ZIP code:

How did you find gshvin.org?

Search Engine

Guessed address from hospital name

  From Billboard

From newspaper

Recommended by friend

Recommended by physician

Link from another site

From radio

From television

From Good Samaritan publication

Other



 

Reason for visiting Good Samaritan Hospital's Web site (please check all that apply):


To visit Web Babies To find a physician To learn more about my health
To learn more information about a diagnosis To browse job listings To browse physician opportunities
To find about events at Good Samaritan
To learn more about the hospital before becoming a patient




Which hospital facilities/services have you used during the last 12 months (please check all that apply)?

Breast Care Center Cancer Pavilion Dayson Heart Center
Emergency Services
Endoscopy Home Care/Hospice
Laboratory
Lifeline
Nephrology/Renal Medicine
Neurology
Obstetrics/Gynecology
Physical Medicine
Primary Care Clinic
Radiology/Imaging/Xray
Rehabilitation Unit
Respiratory Care
Samaritan Center
Same Day Surgery Center
Inpatient Surgery
Welch Diabetes Education Center

How often do you use the internet?

Daily

A few times per week

A few times per month

Rarely

 

Please include me on your mailing list for the following:

Joint Replacement Seminars

A Time for You (Women's Health Event)

Men's Health Tune Up

Kids Care Health Fair

Health Seminars

All hospital events

My name and address are:

Please enter the code below*:


Word Verification