What type of medical practice are you interested in transcription for:
Primary Care
Specialty
Clinic
Hospital
Physical Therapy/Chiropractic
Psychiatry
I am a transcription provider conducting research
Other

How many practitioners/physicians will need to use medical transcription services?
1 - 2
3 - 5
6 - 10
11 - 25
25+

What is your preferred dictation method for your medical transcription service?
Telephone dictation (toll-free)
Handheld digital recorders
Other

What is the approximate average number of lines generated daily, defined as 65 characters including spaces per line?
0 - 100
100 - 500
500 - 1000
1000 - 2000
2000+
Not sure

What type of documents will be dictated for medical transcription (please check all that apply):
Consults
Progress/SOAP notes
Radiology reports
Referral letters
Hospital reports
Telephone notes
Other (please specify): 


Will you require population into an EMR?  If so, which software?
Allscripts
NextGen
Misys
Epic
Other (please specify):  

When will you need this medical transcription service?
ASAP
In one month
In two months
More than two months

What is your zip code?


Your Contact Information:

Name: 

Company Name:  

Email Address: 

Telephone Number:  

Preferred Methond of Contact:
Phone
Email

Please describe any additional requirements you may have for your medical transcription service:


(500 characters or less)

           


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