Request a listing in the TeleHealth World
Industry Directory
Thank you for your interest in requesting your company's free listing in the TeleHealth World Industry Directory. Please fill out all of the information below to request your listing. You may also print this form and fax it to 720-528-3771.
Please complete the following information:
Company*:
First Name*:
Last Name*:
Title:
Address*:
City/State/Zip*:
Country*:
Main Phone*:
Main FAX*:
Main E-mail*:
Website:
*required fields
A: Type of Company:
Association/Society
Education
Event Sponsor
Government Agency
Healthcare Provider (See C: Type of Healthcare Facility)
Publication
Vendor (see F: Products/Services Offered)
Other:
B: Type of Communications/Networks:
Broadband
Cable
Cellular
Fiber optic
LAN
RFID
Satellite
Telephone
WiLAN
WiMax
ZigBee
Other:
C: Type of Healthcare Facility/Organization:
Ambulatory Care
Clinical/Group Practice
Disaster Response
Disease Mgmt
Education
Emergency Response
Employer Health Program
Government Medical Center/Hospital Organization
Home Healthcare
Hospice
Hospital/Multi-Hospital System
Insurance Company
Integrated Delivery System/Health Network
Long-Term Care
Managed Care Organization (HMO, PPO, Health Plan)
Military Medical Center/Hospital Organization
Mobile Healthcare
Nursing Services
Nursing Home
Patient Monitoring
Pharmaceutical Company
Pharmacy/Independent Lab
Physician Organization
Rehabilitation Center
TeleHealth Network
University Medical Center/Hospital
Wellness Program
Other:
D: Types of Specialty/Treatment:
Ambulatory/Emergency Care
Asthma
Autism
Cardiac
Critical Care
Dermatology
Diabetes
Disaster Response
Disease Management
Emergency
Geriatric
High Risk CHF
Long-Term Care
Obesity
Pathology
Psychiatry
Radiology
Other:
E: Types of Monitoring/Diagnostic Systems:
Behavioral
Blood Glucose
Blood Level
Blood Pressure
Cardiac
CO2
Disease Management
Ear, Nose & Throat (ENT)
Electrocardiogram (ECG)
Electronic Stethoscopes
Examination Cameras
Fitness
Health
Otoscopes
Patient Monitors
Pedometers
Pulse Oximeters
Radiography
Retinal
Thermometers
Ultrasound
Vital Signs
Weight Scales
Wellness
Other:
F: Products/Services That you Provide:
Application Services
Audiovisual Equipment
Cable Communications
Call Center
Cameras
Communication Systems/Devices
Connectors/Adaptors
Consulting
Diagnostic Equipment
Diagnostic Services
Digitizers
Fiber optic Communications
Financial Services
Fitness Devices/Equip.
Imaging
Insurance
IT Services/Integration
Legal
Medical Alert Devices/Systems
Medical Alert Services
Medication Dispensing
Mobile Carts/Workstations
Monitoring Devices/Equip.
Monitoring Services
Networks/Servers/Data Storage
Outsourced Medical Services
Patient Self-Management Programs
Pharmacy Solutions
Picture Archiving Systems (PAC's)
Power Supplies
Records Management
Reimbursement
Satellite Communications
Scheduling Systems
Scopes
Software Stethoscopes
Store-and-Foreward Systems/Services
Telecommunications Equipment
Telecommunications Services
Telepresence
Training/Education
Value Added Reseller (VAR)
Video Conferencing Equipment
Video Conferencing Services
Weight Scales
Wireless Communications
Other:
People Please include all key management people, and indicate department or function:
Key:
A
General & Corporate Management
B
R&D / Engineering / Technical / Manufacturing
C
Sales / Marketing / Customer Service
D
Finance / Purchasing
E
Admin / HR / Legal / MIS
F
MIS/IT
Name: Title:
Email: Function / Dept: (click all that apply)
A
B
C
D
E
F
Name: Title:
Email: Function / Dept: (click all that apply)
A
B
C
D
E
F
Name: Title:
Email: Function / Dept: (click all that apply)
A
B
C
D
E
F
Name: Title:
Email: Function / Dept: (click all that apply)
A
B
C
D
E
F
Name: Title:
Email: Function / Dept: (click all that apply)
A
B
C
D
E
F
Name: Title:
Email: Function / Dept: (click all that apply)
A
B
C
D
E
F
Name: Title:
Email: Function / Dept: (click all that apply)
A
B
C
D
E
F
Name: Title:
Email: Function / Dept: (click all that apply)
A
B
C
D
E
F
Please note any addition people (with all of the information above) in the space at the end of this form for other information.
Company Description
Year your company was established:
Annual Revenue from sales of software and related services:
How many total employees does your company have:
Ownership:
Public
Private
Non-Profit
Government
Business conducted from this location:
Headquarters
Manufacturing
R&D
Sales/Distribution
Company description:
Brand Names:
Other information that may be helpful (including extra People information)
