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Full Name*
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Phone
Work Email*
Organization*
Org Website URL
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What is your biggest challenge or pressing priority?
What stage are you at in selecting a telehealth technology provider?
- Just researching
- Ready to buy
Do you have funding for your telehealth program?
- Yes
- No
Timeframe for purchasing decision.
- Now-6 months
- 6 months+
Role
- Recommender
- Decision Maker
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What is the care setting for telemedicine program?