ICA MEMBER SURVEY

Dear ICA Member,

We are sending you this survey with the hopes you will take 5 minutes of your time to complete it and return it to us. As your ICA Representative(s), we wish to create through the ICA, the coordinated network needed to bring about timely mobilization within our state to protect and enhance our practice. Our growth and coordination will ensure our collective practices. Your response, within 14 days would be most helpful and appreciated. Thank you in anticipation of your cooperation!

 

NAME

STREET ADDRESS

CITY

STATE

POSTAL CODE

E-MAIL ADDRESS

PHONE  

FAX

CELL PHONE

 

Please answer the following to the best of your ability

1.        What do you find to be your biggest challenges in practice today?

 

2.        Are you willing to join together with other ICA members to address these and other challenges?

 

3.        What would be the most convenient way for you to participate?

Meetings    E-mail Chats   Teleconference    Other

 

4.        Have you attended an ICA Seminar within the past 5 years?
Which one(s)?

 

5.        What seminars would you be interested in attending?

 

6.        Are you a member of a state association?
Name of Assoc.

 

7.        Do you have any close political contacts?
With whom?

 

8.        Do any of your patients have close political contacts?
With whom?

 

9.        What would you like to see us, in this state, do to bring chiropractic to more people?

 

10.     Are you willing to participate with other ICA members in a coordinated patient education program by photocopying and distributing information to your patients?

 

11.     Have you visited the ICA’s web site this year?

 

12.     Would you use a member’s only site regularly if available?

 

13.     We know that 70% of the chiropractors in practice do not belong to any national association. We know the ICA is actively fighting for your protection in Washington, DC, working to improve your Medicare position, reviewing and recommending viable malpractice insurance, organizing and coordinating state/Province/country activities for the protection of chiropractic’s uniqueness. The ICA is actively addressing the issues attacking chiropractic in Manitoba, Canada, as well as in various states that have requested ICA’s support.

How many non-ICA members do you know?

 

      Are you willing to talk with them about membership in ICA, with the help of your Assembly Representative?

14.      What is a good time for me to call you and at what number?

 

For verification purposes, please type in the numbers and letters that you see below then press the Send Request button

 ICAmembers@aol.com