Let's Connect

This form is designed to help us better understand your cardiac device clinic’s needs and priorities before meeting with a dedicated PrepMD representative. By providing insights into your clinic’s current environment, you will enable us to tailor the upcoming conversation and ensure we address the most relevant topics. Your input will help us offer our support for your clinic.

PrepMD Device Pre-Meeting Clinic Questionnaire
NAME:
NAME:
First Name
Last Name
PATIENT POPULATION:
SOFTWARE USING:
WHAT REMOTE MONITORING SERVICES PARTNER ARE YOU USING?
TOP CLINIC CHALLENGE:
REASON FOR CONVERSATION (CURRENT CLINIC NEED):
TIMELINE FOR SOLUTION:
ARE YOU CURRENTLY HIRING?