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<input type="hidden" id="PAGE" name="PAGE" value="1"><table summary="margins" width="100%" border="0" cellpadding=0 cellspacing=0><tr><td colspan='3' height='36'></td></tr><tr><td width='36'>&nbsp;</td><td><table border="0" cellpadding="0" cellspacing="0" width="100%" class='V2_classT' summary="Question" id="V2"><tr><td align="left" valign="top" width="100%" style="padding:1px 0px;"><font size="+2" color='#59A5D6' face="Tahoma"><b><img src="http://dev.surveys.medaxiom.com/snapwebhost/k/126825459515/slcc_logo.jpg" alt="slcc_logo" width='300' height='101' > &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<font size=+2 color="#000000">Referring Physician Satisfaction Survey</font><font size=+3 color="#000000"> </font></b></font></td></tr></table><table border="0" cellpadding="0" cellspacing="0" width="100%" summary="Spacer" id="V3_SPACER"><tr><td align="left" valign="middle" height="18"><HR size=1 color='#000000' noshade></td></tr></table><table border="0" cellpadding="0" cellspacing="0" width="100%" class='V3_classT' summary="Question" id="V3"><tr><td align="center" valign="top" width="100%" style="padding:1px 0px;"><font color='#3E5268' face="Tahoma">Welcome to Saint Luke's Cardiovascular Consultants Referring Physician Survey. We strive to provide the best service possible to our referring physicians. The feedback and opinions of our referral community are of the utmost importance to us. Please take a few minutes to complete this short, anonymous survey and let us know how we're doing. You will not be asked to enter any identifying information on this survey. There will be no way for the recipients of these survey results to know who submitted them, thereby protecting your privacy and confidentiality. </font></td></tr></table><table border="0" cellpadding="0" cellspacing="0" width="100%" summary="Spacer" id="V129_SPACER"><tr><td align="left" valign="middle" height="35"><HR size=1 color='#000000' noshade></td></tr></table><table border="0" cellpadding="0" cellspacing="0" width="100%" class='V129_classT' summary="Question" id="V129"><tr><td align="center" valign="top" width="100%" style="padding:1px 0px;"><font size="-1" face="Arial"><b><img src="http://dev.surveys.medaxiom.com/snapwebhost/k/126825459515/home_image.jpg" alt="home_image" width='630' height='300' ></b></font></td></tr></table></td><td width='36'>&nbsp;</td></tr><tr><td colspan='3' height='36'></td></tr></table><div align="center"><img vspace='4' src="http://dev.surveys.medaxiom.com/snapwebhost/k/126825459515/satisfaction_survey___referring_physician_line.gif" alt="dividing line"></div><table summary="buttons" width="100%" border="0" cellpadding="0" cellspacing="0"><tr><td  colspan='3' align='center'>&nbsp; <img vspace='4' src="http://dev.surveys.medaxiom.com/snapwebhost/k/126825459515/satisfaction_survey___referring_physician_pbar01.gif" alt="Page 1/7"> &nbsp;</td></tr><tr><td  align='left' width='221'> </td><td  align='center'>&nbsp; <input type="image" border='0'src="http://dev.surveys.medaxiom.com/snapwebhost/k/126825459515/satisfaction_survey___referring_physician_rset.gif" alt="Clear Answers from this Page" name='reset' value="Reset"> <input type="image" border='0'src="http://dev.surveys.medaxiom.com/snapwebhost/k/126825459515/satisfaction_survey___referring_physician_next.gif" alt="Next Page" name='next' value="Next &gt;&gt;"> </td><td  align='right' width='221'> <a href="http://www.medaxiom.com/" title="Link to http://www.medaxiom.com/" target="_parent"> <img border='0' src="http://dev.surveys.medaxiom.com/snapwebhost/k/126825459515/satisfaction_survey___referring_physician_logo.jpg" alt="Link to http://www.medaxiom.com/"></a>&nbsp;</td></tr></table></form>
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