Medical Equipment Survey Question Title * 1. Enter COMPANY NAME: Question Title * 2. Enter YOUR NAME: Question Title * 3. How much of your business comes from Medical Eyecare today? 5 to 10% 10 to 25% 25 to 35% 35 to 50% 50% or more We do NOT actively offer medical eye care services Other (please specify) Question Title * 4. Do you expect this % of your business to change in the next several years (1 to 3 years)? If yes, how much? No Yes (please specify) Question Title * 5. How likely is it that your practice will be purchasing the following EYE LANE equipment in the next 2 to 3 years? Very Likely Somewhat Likely Not Likely Chair and Stand Chair and Stand Very Likely Chair and Stand Somewhat Likely Chair and Stand Not Likely Phoropter Phoropter Very Likely Phoropter Somewhat Likely Phoropter Not Likely Projector and Screen Projector and Screen Very Likely Projector and Screen Somewhat Likely Projector and Screen Not Likely Digital Chart Digital Chart Very Likely Digital Chart Somewhat Likely Digital Chart Not Likely Slit Lamp Slit Lamp Very Likely Slit Lamp Somewhat Likely Slit Lamp Not Likely Keratometer Keratometer Very Likely Keratometer Somewhat Likely Keratometer Not Likely Retinascope Retinascope Very Likely Retinascope Somewhat Likely Retinascope Not Likely Stool Stool Very Likely Stool Somewhat Likely Stool Not Likely Diagnostic Lenses Diagnostic Lenses Very Likely Diagnostic Lenses Somewhat Likely Diagnostic Lenses Not Likely Question Title * 6. How likely is it that your practice will be purchasing the following MEDICAL TESTING equipment in the next 2 to 3 years? Very Likely Somewhat Likely Not Likely Optical Cohereance Tomography (OCT) Unit Optical Cohereance Tomography (OCT) Unit Very Likely Optical Cohereance Tomography (OCT) Unit Somewhat Likely Optical Cohereance Tomography (OCT) Unit Not Likely Retinal Camera Retinal Camera Very Likely Retinal Camera Somewhat Likely Retinal Camera Not Likely Visual Field Analyzer Visual Field Analyzer Very Likely Visual Field Analyzer Somewhat Likely Visual Field Analyzer Not Likely Topographer Topographer Very Likely Topographer Somewhat Likely Topographer Not Likely Pachymmeter Pachymmeter Very Likely Pachymmeter Somewhat Likely Pachymmeter Not Likely Anterior Segment Camera Anterior Segment Camera Very Likely Anterior Segment Camera Somewhat Likely Anterior Segment Camera Not Likely IOL Master / Optical Biometer IOL Master / Optical Biometer Very Likely IOL Master / Optical Biometer Somewhat Likely IOL Master / Optical Biometer Not Likely Question Title * 7. How much do you typically spend per year on this type of equipment? Question Title * 8. Who are your main suppliers for EYE LANE equipment? Question Title * 9. Who are your main suppliers for MEDICAL TESTING equipment? Question Title * 10. If Opti-Port had a program that would offer competitive discounted pricing for this equipment, how likely would you be to purchase through that program? Very Likely Somewhat Likely Not Likely Why? (please specify) Done