Client Name :
  Tele :
  E-mail ID :
Type of Medical Practice :
If others, please specify :
  Preferred Dictation Method :
  How many Physicians will need Medical Transcription :
  Expected turn around time :
  Priority :
  What type of Document will be dictated
  If others, please specify:
  Approximately how many mins of dictation require transcription daily?
  How soon do you require the transcription service?
  Name the reference with contact details: [If applicable] :





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