Before Submitting A Service Request
We highly recommend using the following forms to help you prepare
and gather the necessary information that we require
Project Assessment Forms
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Project Assessment Form - Hospital / Campus |
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Project Assessment Form - Non Hospital / Off Campus |
Product Audit Forms
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Audit Form - (6) Departments / Page |
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Audit Form - (3) Departments / Page |
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Audit Form - (1) Department / Page |
Please Acknowledge The Following...
Individual service requests must be submitted for EACH hospital campus and for EACH off campus facility.
A product audit is required to be attached to EACH service request.
We will NOT schedule our services without a completed product audit.
All service request forms must be submitted a minimum of 21 days in advance.
The project must include a minimum install quantity of 100 units.
All facility locations must be within a 100 mile radius.
If you order extra product, please do not include this in the totals on the service request forms.
Our minimum charge for any project will be for the quantity provided on the service request(s).
And Please Provide Accurate Numbers!
UNDER ESTIMATING the quantity on the service request runs the risk of the install team not having enough time scheduled to complete the project.
OVER ESTIMATING the quantity on the service request will contribute to unnecessary costs.
Choose & Submit Appropriate Service Request Form
Submit One Service Request For EACH Facility Location
Service Request Forms
1. Service Request Form - Hospital / Campus Facility
Please submit this service request for any hospital campus location. This can include all adjacent buildings located on the campus.
2. Service Request Form - Non Hospital / Off Campus Facility
Please submit this service request for any facility that is located off site from the main campus or any facility that is NOT considered a hospital. This can include medical office buildings, professional office buildings, specialty centers, clinics, urgent care centers, etc.