MCS - Apply Online

Phone: 732.607.2400

Email: info@medcomsys.com

Please complete following request to apply online.

First Name*

Last Name*

Organization

Address

City

State*

Zip*

Telephone*

Fax

Email*

Who are your current customers?

Hospitals (Less than 100 beds)

Hospitals (100-500 beds)

Hospitals (More than 500 beds)

Solo Physicians

Physician practices (Less than 25 physicians)

Physician practices (25-50 physicians)

Physician practices (50-100 physicians)

Physician practices (More than 100 physicians)

Home Health Agencies

Military Health Sector

Any specialties, which you are more familiar selling to?

What all you have been selling
to healthcare community?

Transcription Solutions (Specify)
Scheduling (Specify)
Billing & A/R (Specify)
Revenue Cycle Services (Specify)
Document Management (Specify)
Remote Billing Services (Specify)
Medical Equipment/Supplies (Specify)

What is average annual sales volume
of your last 3 years sales to physicians?

How many sales people have
you been employing?

How many technical support
people have you been employing?

What geographic are as are
your strong-holds?

How did you hear about
Medical Communication Systems?

Any other comments

( * indicates mandatory fields )

Apply Online