Medical Transcription Services Your Name*: Company Name*: Address: Your Email Address*: Zip Code: City, State: Your Phone Number*: What do you specialize in*? Average number of lines, pages/per day, month? Number of people transcribing*? 1. What is the transaction that your company are interested in*? Medical General Media Business Legal 2. How do you currently do your transcription? In-house Contract 3. Current transcription method? Digital Dictaphone DVD/VCD/CD Tape Web interface Toll free service Telephone conference Not applicable EMR On computer Other 4. How would you prefer to do your transcription*? Digital Dictaphone Toll free service Tape Remote transcription Other 5. How would you prefer to receive your transcription*? Remote Transcription Email File Transfer Software Other 6. Your Monthly / Yearly transcription expense? 7. How soon would you like to use our service*? 8. Additional information

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