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First name:
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Last name:
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Email Address:
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Retype Email Address:
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Phone number:
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Business/Facility Address 2:
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City:
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Do you work in a:
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Physician Office Lab
Independent Reference Lab
National Lab
Acute Care Hospital
Other
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If you answered ‘other’ in the question above, where do you work?
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Please fill in the specialty or specialties your facility services:
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If you work in a hospital, what is your hospital's bed count?
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When working in an independent patient care facility, how many patients on average do you care for in a day?
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What is the biggest challenge in your facility?
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