Client Questionnaire

 
Practice Name:
Medical specialty:

PROVIDER DETAILS

1. How many dictators would utilize this service?
1-3
3-5
5-10
10-15
More than 15 
   
Please provide the names

 
2. Do you have multiple locations or satellite offices?
YES     NO

 

If Yes,
1-2
2-4
4-6
More than 6
  
3. Average number of minutes each dictator dictates every day
5-10 Minutes
10-15 Minutes
15-20 Minutes
More than 20 Minutes
 
4. What is your preferred dictation method?
   Hand-held digital recorders
   Dictation through telephone (toll-free)
 
5. Do you need STAT support (4-hour-TAT)?
   Yes
   No
   

FILE TRANSFER

 
6. We offer the following modes of secure, HIPAA-compliant file transfers; please select your preferred mode of file transfer
a)
Pradot Transcription Office Manager (TOM) offers,
 
Key features of TOM:
  • Upload voice files
  • Download transcribed files
  • Track dictation
  • Review transcriptions online and do online corrections
  • Add digital signature
b)
Secure FTP site (FTP over SSL/SSH)
c)
Encrypted e-mail upload
Please provide the e-mail ID
   
d)
Transfer to your FTP site, if you have your own FTP site for uploading files back to you. Please provide the FTP details
 
e)
Through RDP (remote desktop protocol)
   
TRANSITION
  
7. To help us serve you better, we request you to provide us the following
Soft copy of all the templates
Page setup details
Samples of all types of reports
A copy of standard review of systems/physical examination, if any exist
Macros/normals for review of systems/physical examination/standard phrases, if any exist
If there are any specific formatting guidelines to be followed for any
particular physician, please attach a copy of the same
Referring physician database

  

Please send all the above to:

Vial e-mail: support@pradot.com
Via fax: 1-866-614-2379


8. Do we need to scan your letterheads to enable plain paper printing?
  Yes
  No

If yes, please mail a hard copy of your letterhead to:
Arun Murali (President – US operations)
5546, Primrose Avenue
Indianapolis, IN 46220

 

CONTACT DETAILS
Name and contact information of the key person who would coordinate transcription work
(Front office coordinator or equivalent)
Name:
Designation:
Tel:
Fax:
E-mail:
 
(Practice manager or equivalent)
Name:
Designation:
Address ::
Tel:
Fax:
E-mail:
If there is any additional information you would like to provide us, please enter it below:

 

 

 

   

 

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