Customer Conference Pre-Event Survey        
Thank you for taking our Pre-Event Survey! Your responses will help us focus the content on the topics that matter to you. Individuals who fill out this survey will be entered in a draw to win a free registration pass to their local Picis Conference.

If you have any additional questions about this event, please contact Melanie Klein mklein@picis.com 516-255-7904

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Name *
Title *
Hospital Name *
Which regional conference would you like to attend? *
Which Picis modules does your facility(s) currently own/use? *
Required
Which modules do you wish your facility(s) owned/used? *
Required
Which Tuesdays with Theresa have you enjoyed most? (Choose 1-3) *
Required
On which Tuesdays with Theresa topic do you feel most knowledgeable? (Choose 1-3) *
Required
Are you able to bring a laptop with you? *
Are you able to remote access your Test environment(s) on your laptop? Please include details if not a 'Yes' or 'No' *
Have you been to a Picis Customer Conference before? If so, which year(s)? *
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