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about
– our story
– team
– services
connect
– contact
– on-site service
– submit doctor’s orders
– become a customer
– employment
resources
– ordering
– app
– quick links
– toolkit
– make a payment
search
Schedule an On-site Service
Wendy Ruel
2024-11-08T06:30:00-06:00
SCHEDULE YOUR ON-SITE SERVICE
We aim expertise in your direction.
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Name
*
First
Last
Phone
*
What's your facility name?
*
How many locations do you have?
*
When we aim our expertise in your direction, which states do you operate in?
*
Select all that apply.
Missouri
Kansas
Arkansas
Oklahoma
Nebraska
Iowa
Other
Not Applicable
What's the address of your primary location?
*
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
What's the best way for us to respond to you?
*
Call
Text
Email
Mobile phone
*
Standard messaging rates apply.
Email
*
Which services would you like to get underway?
*
Select all that apply.
eMar/EHR Demo
In-service Education
Vaccinations (Sept, Oct, Nov)
First Aid/CPR Certification (4-10 staff)
Pharmacist Consultation
Pharmacist Inspection
Pharmacist Drug-Regimen Review
How many do you estimate will be in attendance for your eMAR/EHR Demo?
*
For your eMar/EHR Demo, which month will be best for your service?
*
Select all that apply.
January
February
March
April
May
June
July
August
September
October
November
December
For your eMar/EHR Demo, which day of the week will be best for your service?
*
Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Not sure yet ... let's chat
Which day of the week will be best for your eMar/EHR Demo?
*
Select all that apply.
Early morning
Late morning
Early afternoon
Late afternoon
Early evening
Not sure yet ... let's chat
How many do you estimate will be in attendance for your HRST Solution Demo?
*
For your HRST Solution Demo, which month will be best for your service?
*
Select all that apply.
January
February
March
April
May
June
July
August
September
October
November
December
For your HRST Solution Demo, which day of the week will be best for your service?
*
Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Not sure yet ... let's chat
Which time of day will be best for your HRST Solution Demo?
*
Select all that apply.
Early morning
Late morning
Early afternoon
Late afternoon
Early evening
Not sure yet ... let's chat
How many do you estimate will be in attendance for your In-service Education?
*
For your In-service Education, which month will be best for your service?
*
Select all that apply.
January
February
March
April
May
June
July
August
September
October
November
December
For your In-service Education, which day of the week will be best for your service?
*
Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Not sure yet ... let's chat
Which time of day will be best for your In-service Education?
*
Select all that apply.
Early morning
Late morning
Early afternoon
Late afternoon
Early evening
Not sure yet ... let's chat
How many do you estimate will be in attendance for your Vaccinations?
*
For your Vaccinations, which month will be best for your service?
*
Select all that apply.
September
October
November
For your Vaccinations, which day of the week will be best for your service?
*
Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Not sure yet ... let's chat
Which time of day will be best for your Vaccinations?
*
Select all that apply.
Early morning
Late morning
Early afternoon
Late afternoon
Early evening
Not sure yet ... let's chat
For your First Aid/CPR Certification, attendance is limited to 4-10 staff. How many will be attending?
*
4
5
6
7
8
9
10
Unknown
First Aid/CPR Certification is limited to 4-10 staff, please list names of those attending:
*
Additional lines should be added for each attendee.
Add
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When do you anticipate having exact attendance numbers for First Aid/CPR Certification? We’ll reach out and connect at that time.
*
For your First Aid/CPR Certification, which month will be best for your service?
*
Select all that apply.
January
February
March
April
May
June
July
August
September
October
November
December
For your First Aid/CPR Certification, which day of the week will be best for your service?
*
Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Not sure yet ... let's chat
What time of day will be best for your First Aid/CPR Certification?
*
Select all that apply.
Early morning
Late morning
Early afternoon
Late afternoon
Early evening
Not sure yet ... let's chat
For your Pharmacist Consultation, which month will be best for your service?
*
Select all that apply.
January
February
March
April
May
June
July
August
September
October
November
December
For your Pharmacist Consultation, which day of the week will be best for your service?
*
Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Not sure yet ... let's chat
What time of day will be best for your Pharmacist Consultation?
*
Select all that apply.
Early morning
Late morning
Early afternoon
Late afternoon
Early evening
Not sure yet ... let's chat
For your Pharmacist Inspection, which month will be best for your service?
*
Select all that apply.
January
February
March
April
May
June
July
August
September
October
November
December
For your Pharmacist Inspection, which day of the week will be best for your service?
*
Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Not sure yet ... let's chat
What time of day will be best for your Pharmacist Inspection?
*
Select all that apply.
Early morning
Late morning
Early afternoon
Late afternoon
Early evening
Not sure yet ... let's chat
For your Pharmacist Drug-Regimen Review, which month will be best for your service?
*
Select all that apply.
January
February
March
April
May
June
July
August
September
October
November
December
For your Pharmacist Drug-Regimen Review, which day of the week will be best for your service?
*
Select all that apply.
Monday
Tuesday
Wednesday
Thursday
Friday
Not sure yet ... let's chat
What time of day will be best for your Pharmacist Drug-Regimen Review?
*
Select all that apply.
Early morning
Late morning
Early afternoon
Late afternoon
Early evening
Not sure yet ... let's chat
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