Quality Outsourcing since 1989
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REQUEST FOR PROPOSAL

Are you interested in receiving more information on our services?  Please complete the following.  We will contact you within 24 hours.

All requests will be kept confidential and your information will not be disclosed to any other party.

* indicates required field

*Title:                

*First Name:       

*Last Name:       

*Facility Name:   

*Phone:             

*Email:              

Services needed (select all that apply):

Complete hospital medical records  
Overflow hospital medical records  
Specialty clinic                   
Overflow specialty clinic        
Small private practice             
p.r.n. coverage for my facility    
Radiology only                     
Surgical center                  
Emergency room only                
Non-medical transcription          

When are services needed:

Immediately
Within the next few weeks
Within the next 3 months
Sometime this year

Approximately how many providers: 

Preferred method of dictation:

Call-in                                      
Handheld                           
USB speech microphone              
Digital transfer from your system

How did you hear about us?


Additional comments: