Contact Information:

Name:

Title:

Company:

Address:

City / State / Zip:

Phone:

Fax (if available):

E-Mail:

Please briefly list your experience as it relates to this awards program:

Specialties: (check all that apply)
Note: Any specialties you check will help us assign entries that are focused in your area of expertise.

Consulting
Education
Food Industry
Government
Managed Care
Home Health Care
Hospital/Health Care Systems
Insurance
Media/Publishing
Medical Communications
Medical Equipment/Supplies
Nonprofit
Nurse/Allied Health Professional
Pharmaceutical
Physician
Graphic/Web Design
Mobile Application Design/Programming

Which Tools Will You Have Access to for Reviewing Digital Health Information?
(check all that are available to you)

Microsoft Excel or other spreadsheet software
Web browser (latest versions of Internet Explorer, Firefox, Safari, etc.)
Android Device - Small (Smart Phone, etc.)
Android Device - Large (Tablet)
Apple iPhone / iPod touch
Apple iPad
BlackBerry Device - Small (Smart Phone)
BlackBerry Device - Large (Tablet)
Windows Mobile Device - Small (Smart Phone, etc.)
Windows Mobile Device - Large (Tablet)
Ability to stream or download and play Web-based audio and video

For more information about judging the Web Health Awards, contact us at 1-800-828-8225, weekdays 9-5 Central time.