EXECUTIVE BUSINESS SERVICES

Medical Transcriptionists Service
Phone: 856-489-6780    Fax: 856-489-6781

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To request a FREE QUOTE, please fill out the form below.

Your
Name
Practice
Address
City State
Zip
Phone Email
  
What is the medical specialty of the practice?
How many physicians will be dictating?
Are there any foreign dictators? Yes
No
What documents will be dictated ?

Letters
Reports
Notes
Other - Please describe.

How many pages of dictation do you expect to generate per week?
What dictation methods are you currently using?
Tapes: Micro
Mini
Standard
Digital: Phone
Hand Held
Do you want EBS to print out your transcribed work or do you want us to forward the documents to you for printing? EBS does printingClient does printing
If we are to do the printing, are you going to require copies? Yes
No
If the answer to the above is yes, how many?
What are your turn around requirements?

Days Minimum
Days Maximum

Will EBS be the sole provider for your transcription needs or for overflow only?

Sole Provider
Overflow Only

Are you presently using an off-site transcription service?

Yes
No

If  yes. do you plan to continue utilizing an off-site transcription service? 

Yes
No

Do you currently have in-house-staff transcriptionists?

Yes
No

If yes, do you plan to continue using your in-house transcriptionists?

Yes
No

How would you like your estimate to be quoted?

Line
Page
Hour
Report

How do you want to receive your quote? Email
Phone
US Mail
How did you hear about us?

If you have any additional comments, questions or special requests, please address these in the space below:


      

EXECUTIVE BUSINESS SERVICES
EBS Medical Transcriptionists Service
P
hone: 856-489-6780    Fax: 856-489-6781

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