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© 1996-2006 MMRx, Inc.
Medical Marketing Research, Inc
1201 Melton Court
Raleigh, NC 27615
Phone: (919)870-6550
Fax: (919)848-2465
E-Mail:info@mmrx.com

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Request a Proposal
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Use this page to request a proposal for a Quantitative Study:

Fill out this form and we will contact you with a research proposal.

Contact Information (all fields required):
Contact Person:
Company:
Street Address:
City:
State:
Zip:


Phone:
Fax:
E-mail:
I prefer to receive
my proposal via:
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Study Design (Quantitative Study):
Study Type:
If Other,
Please Specify:
Data Collection:
If Other/Multiple Types,
Please Specify:
Number Desired:
City Preference (if any):
Medical Specialty:
If Other/Multiple Types,
Please Specify:
Will this study occur
in conjunction with
a medical convention?
Yes No
If Yes, Which One?

Project Timeline:
Project Dates:
Report Date:
Final Completion Date:
Briefly Describe This Project:


For questions about your proposal, contact us at: rfp@mmrx.com