Contact / Request Quote
Client Name:
Specialty:
Your Street Address:
City:
County:
Post Code:
Contact Name:
Telephone Number:
Your E-mail:
*
Reports per week needed:
<50
<100
<250
<500
500+
Requested Turn-around Time:
<24 hrs
<36 hrs
<48 hrs
<72 hrs
72 hrs +
Method of Dictation:
Hand held digital recorder
Existing dictation system at my practice
Other digital recording method
Tapes
Remote phone-in
Open to suggestions
WPW Software:
MS Word
WordPerfect
Other
Doesn't matter
Is this a One-time Project?
Yes
No
Is STAT Required?
Yes
No
Will a foreign accent be transcribed?
Yes
No
Integrate with existing system MIS?
Yes
No
(Please specify below)
Additional Comments such as model/version of existing system, special needs, etc:
*
All information given to ACT Transcription is treated as confidential and your email address will only be used to contact you regarding your inquiry.
