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* 1. What sort of organization are you working for (Please check one)?

* 2. Please check the type of work that best describes what you do (Please check one):

* 3. What are the top 3 social media issues of current interest to your company?

* 4. Who are the stakeholders that you would like to target using social media channels over the next 6-12 months? (Please check all that apply.)

* 5. Please indicate your company’s readiness to establish a presence in social media over the next 6-12 months using the scale from 1 to 6 as described below? (Please check one.)


* 6. What support does your company need to establish and / or maintain a presence in social media over the next 6-12 months? (Please check your top 3 responses.)

* 7. If you are interested in The Research Doctor Inc. contacting you to help your company establish and / or maintain a social media presence, please provide your business card or complete the information requested below. We look forward to meeting with you soon!

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