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New Contract Registration

Business Details
In order to open an account, please complete the section below which relates to your Practice / Company information.
NB. The person completing this form will be registered as the contract account manager only.
Registration of author/s can only be done on the website once the manager has a User ID and Password.
These details must be completed even if registering as an individual.
Practice / Company name: *
Company/ Practice Reg No:
Professional Practice No:
Profession: *
Tel: *
Fax:
Physical Address: *
City: *
Postal Address: *
Postal Code: *
Country: *
Language:
Password: * (Choose your own 4 digit numeric code not beginning with a 0)
Retype Password: *
 
Primary Contact Person's Details
Name: *
Surname: *
Tel: *
Fax:
Cell: *
Email: *
ID no:
 
Alternate Contact Person's Details (Recommended)
Name:
Surname:
Tel:
Fax:
Cell:
Email:
ID no:
 
 
The following information is required in order to enable us to adequately assess your specific requirements and quote accordingly
 
Additional information
Type of documents: Reports:      Letters:      Other:     
Dictation method currently in use:
Make:
Computer operating system:
Internet connection:
Would you like to use our telephonic Fastline:    Yes     No
Would you like us to send a sales executive to demonstrate and advise you
on handheld digital recorder or other digital options:
    Yes     No
 
Transcription volumes
Indicate which measurement unit you prefer to indicate volume of work:
Weekday 08:00 to 17:00 hrs CAT:
Weekday 17:00 to 08:00 hrs CAT:
Weekends 08:00 to 17:00 hrs CAT::
Weekends 17:00 to 08:00 hrs CAT:
Average length of documents (Words):
What is your document turnaround time requirement:
Standard turnaround time:
Priority turnaround time:
 
Existing typing facilities
Own in house typists: Yes     No     If yes how many:
Do you intend to keep using them: Yes     No
Are you presently using another offsite transcription service: Yes     No
Do you intend to continue to use them: Yes     No
Do you want to use for:
All dictation: Yes     No
Overflow only: Yes     No
After hours weekdays only: Yes     No
After hours weekend days: Yes     No
After hours weekend nights: Yes     No
for completion of unfinished jobs after hours only: Yes     No
 
How did you get to know about our service:
Are you aware of other customers who might value our service:    Yes     No
If yes please supply details:
Name:
Phone: 
Email:
I Accept all the Terms and Conditions:     View Terms and Conditions     View Typist Confidentiality Policy
* Required Fields
NB: Information supplied on this page, is not stored once you leave it, unless you complete the registration process.
warrants to safeguard the confidentiality of your personal information and undertakes not to sell, rent, share or trade your Personal Information to any third party for marketing or any other purpose.
Please also see our "Confidentiality Policy for the Use of Protected Health, Legal and other Confidential Information" which is the fundamental ethic.
 
 
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