Request A Quote

In order for us to provide an accurate quote, please complete the following questionnaire:

*Client Name:  

*Telephone:      Fax:  

*E-mail Address:  

1.  Type of medical practice:

Select one Primary Care Specialty Clinic Hospital Physical therapy/Chiropractic Psychology/Psychiatry Dental/Oral Surgery Other    Specialty/Other (please specify):  

2.  Preferred dictation method:

Select one Telephone dictation (toll-free) Handheld digital recorder PC/microphone

3.  Preferred document delivery method:

Select one Fax E-mail Download from server

4.  How many physicians/practitioners will need medical transcription?

5.  Expected turn around time:

Standard Select one 6-12 hours 24 hours 48 hours 72 hours    Priority Select one 6-12 hours 24 hours 48 hours 72 hours

6.  What type of documents will be dictated?

Select all that apply (Ctrl+selection) History and Physical Discharge Summary Clinic Note Consultation Referral Letter Operative Report Progress Note Independent Medical Examination    Other (please specify):  

7.  Approximately how many minutes of dictation require transcription daily?

Select one 0-10 11-50 51-100 101-200 200+ Not sure

8.  How soon do you require the transcription service (please specify)?

9.  Name of referring physician/practice if applicable.