Top Executive Nomination - The Healthcare Technology Report The following survey should take approximately ten minutes to complete. In order for your nomination to count, all of the asterisks items must be filled in. Your response to question #11 carries the most weight in our evaluation of the executive. Question Title * 1. Add your executive nomination for Top Medical Device Executives Top Biotechnology Executives Top Healthcare Software Executives Other (please specify) Question Title * 2. Executive’s Name Question Title * 3. Executive’s Title Question Title * 4. Company Name Question Title * 5. How would you best categorize the Company? Software and Data Medical Devices Consumer Internet Biotech Other (please describe) Question Title * 6. How do you know the executive? Current Employee at same company Former Employee at the same company Colleague in same industry Self Other (please describe) Next