First Name

Last Name

Job Title

Company

Email

Cell Number

Website

What are your key departmental objectives over the next 6-12 months?

What is your current technology stack?

How many people report to you? (Both directly and indirectly)

Are you the final decision maker? Yes No Part of the decision making group

Who is the final decision maker?

Number of beds?

What is your total budget over the next 12 months?

Please describe your current projects or initatives.

Please describe your ongoing technology implementations or initiatives?

What non-budgetary challenges do you anticipate?

What 3rd parties are you hoping to meet with?

What is your timeline for implementation?

What is your budget for this project?

Anything else you would like to let us know?

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