|
|
Please type responses here: |
|
First name:
|
|
|
Last name:
|
|
|
Email Address:
|
|
|
Retype Email Address:
|
|
|
Phone number:
|
|
|
Company Name:
|
|
|
Job title:
|
|
|
Business/Facility Address:
|
|
|
Business/Facility Address 2:
|
|
|
City:
|
|
|
State:
|
|
|
Country:
|
|
|
Zip/Postal Code:
|
|
|
Do you work in a:
|
Physician Office Lab
Independent Reference Lab
National Lab
Acute Care Hospital
Other
|
|
If you answered ‘other’ in the question above, where do you work?
|
|
|
What is your primary job role?
|
Bioinformatician
Core Facility / Service provider
Department Head
Director
Lab Manager
Molecular Pathologist
Physician / Medical Doctor
Purchaser / Procurer
Research Assistant / Lab Technician
Scientist / Associate Scientist
Student / Graduate Student
Other
|
|
I am interested in following molecular solutions:
|
Pharmacogenomics (PGx)
Antibiotic resistance (ABR) assays
Gastrointestinal infection (GI)
Nail infection
Respiratory tract infection (RTI)
Urinary tract infection (UTI)
Vaginal & Sexually transmitted infection (STI)
Wound infection
N/A
|
|
Are you planning to bring on a PGX test in your lab in the next 12 months?
|
0–6 months
6–12 months
No, I attended this webinar for educational purposes
|
|
By registering for this webinar, Whitehat uses your information to communicate with you regarding this webinar and other educational events. For a link to our privacy policy, which may be pertinent if you are based outside the United States, we encourage you to visit: https://www.whitehatcom.com/privacy_policy.htm.
|
Yes, I consent to give my information to receive communication regarding this webinar
|
|
By clicking the box below, I am happy to receive marketing and promotional email and telephone call communications about products, services, promotions, and events from Thermo Fisher Scientific Inc. and its affiliates in accordance with the Thermo Fisher Scientific Privacy Notice (https://www.thermofisher.com/us/en/home/global/privacy-policy.html)
|
Yes, I would like to receive marketing and promotional communications as indicated above
|
After clicking 'submit',
you will be redirected to the webinar recording.
You will also
receive an email with the link to the evaluation to fill out
after you finish the recording. |
|
|
