Prodatacare

*Name of Org./Physician Name :

*Phone No :

*Email :

*Type of Facility : Hospital Physician Practice Group

*Speciality Allergy/Immunology Arthritis/Rheum Bariatric Cardiology Chiropractic Dermatology ER Endocrinology Family/Primary Care Forensic Medicine GI Ob/Gyn Hem/Oncology Ophthalmology Orthopedics Osteopathy Pathology/Lab Physical Therapy Pediatric Psychiatry Pulmonology Radiology Social Work Speech Therapy Surgery-General Surgery-Hand Surgery-Neuro Surgery-Ortho Surgery-Pediatric Surgery-Plastic Surgery-Thoracic Others

*Speciality:

*Dictataion Method : Phone Handheld Recorder Other - Please Specify

*Turn Around Time(TAT) : Next Day(16-24hours) Same Day

*Special Formatting : Standard Format Same Format for all Multiple Format Custom Tagging/Coding

*How soon do you need the service : Immediately Within 1 Month Within 2-4 Month Within 4-6 Month

*

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