Comprehensive Program Assessment
Explorative Questions
Name
*
First Name
Last Name
Company Name
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Types of Testing you do
You can select more than one testing option
What process are you using for Urinalysis testing?
*
Sending to Reference lab
We have our own in-house DipStick reader
Manually review Urine test strip
Not currently using
Unsure
Other
What process are you using for FISH testing?
*
Sending to Reference lab
We have our own in-house lab for cultures
We have our own high complexity PCR lab
Not currently using
Unsure
Other
What process are you using for Fungal testing?
*
Sending to Reference lab
We have our own in-house lab for cultures
We have our own high complexity PCR lab
Not currently using
Unsure
Other
What process are you using for GI testing?
*
Sending to Reference lab
We have our own in-house lab for cultures
We have our own high complexity PCR lab
Not currently using
Unsure
Other
What process are you using for PGx testing?
*
Sending to Reference lab
We have our own in-house lab for cultures
We have our own high complexity PCR lab
Not currently using
Unsure
Other
What process are you using for RPP testing?
*
Sending to Reference lab
We have our own in-house lab for cultures
We have our own high complexity PCR lab
Not currently using
Unsure
Other
What process are you using for UTI testing?
*
Sending to Reference lab
We have our own in-house lab for cultures
We have our own high complexity PCR lab
Not currently using
Unsure
Other
What process are you using for Wound testing?
*
Sending to Reference lab
We have our own in-house lab for cultures
We have our own high complexity PCR lab
Not currently using
Unsure
Other
What is your current patient flow monthly?
*
50-250
250-500
500-750
750-1000
1000+
What percentage of your patient flow is Medicare?
*
10% or less
20% to 30%
40% or more
How many providers are at your practice?
*
How many locations?
*
Have you ever explored implementing an In-office Laboratory?
*
Yes
No
If you answered yes, what are your biggest concerns?
What is your practices current CLIA Status?
*
High Complexity
Moderate Complexity
Waived
Unsure
What is your most important talking point?
*
Compliance and Regulations
Pricing and Return on Investment
Ease of Set up
Not knowing where to start
Would you like a Doc Lab representative to contact you?
*
Yes
No
How did you hear about us?
*
Online Search (e.g., Google, Bing)
Social Media (e.g., LinkedIn, Instagram)
Company Website
Event or Conference
Referral
Who were you referred by?
Additional comments or concerns?
Submit
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