American Society for Dermatologic Surgery

* Please rate the significance at your practice of the ways that new patients find you:

  Important Somewhat important Somewhat unimportant Unimportant
Physician referral
Other referral websites
Dermatologist referral
Patient referral
Local / phonebook advertising
Internet search
ASDS website referral
Insurance network

* How do you currently promote your practice to referring physicians? (Choose all that apply.)

* What would assist you in marketing your practice to referring physicians? (Choose all that apply.)

* On average, how many skin cancer referrals do you get each month?

* From which physicians do you receive referrals for skin cancer procedures? (Check all that apply.)

* Why do referring physicians choose to refer skin cancer patients to you over other providers? (Choose the top three.)

* On average, how many cosmetic referrals do you get each month?

* From which physicians do you receive referrals for cosmetic procedures? (Check all that apply.)

* Why do referring physicians choose to refer cosmetic patients to you over other providers? (Choose the top three.)

* To inform referring physicians about our specialty, which educational video delivery option do you believe is the best choice?

* In which of the following online physician-only communities do you participate? (Choose all that apply.)

* Any additional comments about referring physicians – relationships, materials or opportunities?

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