Coenzyme Q10 Survey Form

The goal of this survey is to measure Clinicians' anticipated demand for Coenzyme Q10 Blood Assays from the University of Washington. If the total Washington State demand is high enough at the low price end, we intend to expend development effort to robot as many of the 14 steps as possible in the present test, thus bringing costs down.

Instructions

Please answer the following question regarding your anticipated test usage and fill out the contact information.


Survey Questions

Give a rough estimate of the number of Coenzyme Q10 blood assays that you think might be requested from UW Lab Med each month for patients in your practice as a function of price. Do this by estimating what the response would be at each of the three hypothetical prices given below.

Anticipated Number of Tests Per Month At

Contact Information

Name

Practice

Address

Phone Number

Fax Number

Email Address


John T.A. Ely, PhD
Res. Assoc. Professor (Emer.)

ely@u.washington.edu