Clinical Solutions Free Quote Request Home › Contact › Clinical Solutions Free Quote Request Name (required) Title ---Mr.Ms.Dr. E-mail (required) Phone Organization (required) Organization type (required) ---HospitalImaging centerOther Type (if other) Location City / State / Country How did you hear about us? ---Internet SearchReferralJournalsMeeting/Event Type of equipment X-Ray # of units CT # of units MRI # of units Other IT Set Up: Virtual Server Other Other Preference IT Preference Individual CPU Centralized Server Other Other: PACS System/Workstation: Dose Monitoring System: Backup System: Connection Speed: Use Primary use: General Pediatric Other Other Priority Priority need: Image Improvement Radiation Dose Reduction Number of Protocols (Routine and Extended) How are you addressing MITA XR 29? Do you currently market that you provide low dose treatments? Yes No Is this purchase currently in an approved budget? Yes No When would this purchase be scheduled for installation? Are you part of a GPO? Yes No Which GPO? Who is responsible for making purchasing approval? Is this a competitive quote? Yes No If yes, what other firm(s) are quoting? Would you prefer a capital purchase quote or subscription quote? Capital Purchase Subscription Would you consider being a Reference Site? Yes No Do you have a Discount Code? Yes No Enter Discount Code What are your plans for future Radiology Equipment and Software purchases? Thank you for taking the time to complete this information. You can expect your quote within three business days.