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Healthcare & Pharma

MEDICAL SERVICES USED AT HOSPITAL OR OTHER MEDICAL FACILITY PAST 3 YEARS*
  • Any Overnight Stay Procedure
  • Cancer/Oncology
  • Cardiac Care
  • Corrective Eye Surgery
  • Cosmetic Surgery
  • Hospital Emergency Room
  • Maternity Care
  • Mental Healthcare
  • Neurology
  • Orthopedics
  • Pediatrics
  • Teeth Whitening, Veneers, etc.
  • Treatment for Substance Abuse, Smoking, or Nutrition
  • Urgent Care Facility (Excluding Emergency Room)
  • Other Medical Services
HEALTHCARE SPECIALISTS USED PAST 12 MONTHS
  • Cardiologist
  • Chiropractor
  • Dentist
  • Dermatologist (Skin Doctor)
  • Fee-Paid Weight Loss Program
  • OB/GYN
  • Ophthalmologist (Eye Doctor)
  • Optometrist (Eye Examiner)
  • Cosmetic Surgeon
  • Podiatrist (Foot Doctor)
  • Other Specialist
STORES BOUGHT GLASSES/CONTACT LENSES PAST 12 MONTHS
HOSPITALS USED PAST 3 YEARS*
PHARMACEUTICALS
  • Places Purchased Prescription Drugs/Non-Prescription Drugs/Health/Beauty Items Past 30 Days
REASONS BOUGHT MEDICATIONS (OTC/Rx) PAST 12 MONTHS
  • Allergies
  • Arthritis
  • Asthma
  • Children’s Medicine
  • Cholesterol
  • Cold or Flu
  • Diabetes
  • Digestive Disorder
  • High Blood Pressure
  • Impotence/Erectile Dysfunction (ED)
  • Quit Smoking
  • Weight Loss
  • Other
PLANNING TO SHOP FOR NEXT 12 MONTHS*
  • Nursing Care, Assisted Living or Retirement Facility
HEALTH INSURANCE
  • Type
  • Insurance Provider
    • Group
    • Individual
LIFE INSURANCE
BELONG TO A HEALTH/FITNESS CLUB
CONTRIBUTED TO HEALTHCARE/MEDICAL ORGANIZATION*
 
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