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Market Image Assessment Form
Assessment Form - Please take a few minutes and help us help you.
ASSESSMENT FORM
Market Image Consultants will ask you a number of questions in a moment, but before we begin, tell us a little bit about your objectives, your situation, your marketplace, your target audience, etc.
Feel free to tell us as much or as little as you like.
Please select some of your medical facility's objectives below:
Enhance medical facility's reputation
Increase the number of patients the medical facility attracts
Target specific insurances, employers, and government
Reduce our medical facility's over-reliance on a small number of referral sources
Take medical facility to the next level
Make our medical facility recognized as a leader in the field
How much would you like to increase your medical facility's profits over the next 12 months?
Please Select
25% or less
25% to 50%
50% to 100%
Over 100%
How would you rate your current medical facility's marketing program?
Please Select
Highly effective
Somewhat effective
Not effective
NA: I do not have a marketing program.
First Name
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Last Name
(required)
:
Email
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:
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Country:
Phone:
