* First Name:
* Last Name:
* What is your specialty: practicing ophthalmologist ophthalmic fellow or resident optometrist other
* Which best describes your professional classification (fill in one only): member of group solo practitioner academic/teaching fellow/resident military/armed forces Other
* Function (please check all that apply): Academic Legal Regulatory Affairs Finance Manufacturing/Processing Reimbursement Business Development Market Research Sales management Clinical Marketing Scientific Consultant Media Planning Supply Chain Corporate Management Medicare/Medicaid Technology Transfer Drug Safety Medical Affairs Validation Engineering Meeting Planner Clinical research Environmental Packaging Commercialization Managed Care Procurement Compliance HR Project Management Outcomes IT QA/QC Pharmacy Lab Management R&D Other