Free Estimate — Gulf Coast Transcription of Florida, Inc.

Free Estimate

Contact Information

	Fields in bold are REQUIRED.
First Name
Last Name
Company
Phone
Fax
E–mail
Address 1
Address 2
City
State
Zip

Business Information

Medical specialty
How many physicians will be dictating?
What type of documents will be dictated?	Reports Letters Forms Other (Please Specify)
How many documents do you generate per week?
How much turn–around time will you require?	Minimum Maximum
Will you be looking for us to be your sole provider or for overflow only?	Sole provider Overflow only
Do you currently use an off–site transcription service?	Yes No
Do you currently use in–house staff to transcribe?	Yes No

Other

How would you like your estimate to be quoted?	Line Page Report
How would you like to receive your quote?	E–mail U.S. Mail Phone
Additional questions or comments