Organization/Company Name * : |
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Contact Person Name* : |
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Phone* : |
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Fax* : |
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Email* : |
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Type of Facility : |
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No. of Locations : |
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No. of Health Care Professionals who would be using our service : |
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Specialty :
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Average Number of reports/week : |
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Mode of Dictation : |
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If other : |
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Turnaround Time : |
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Hours : |
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Special Formatting : |
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What amount of work do you currently outsource : |
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What amount of work would you like Metaphrase to bid upon : |
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How soon do you need the service : |
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How did you hear about us : |
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If other : |
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Please add any additional comments or information : |
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