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Healthcare Consultation Form
Healthcare Vertical
*
Select
Hospital
Laboratory
Healthcare Aggregator
Clinic
Diagnostic Centre
Others
Company Name
*
Enquirer Name
Email Address
Phone
*
Employees
*
Marketing Staff
*
BD/Sales Staff
*
Consultation Needed For
*
Marketing
Business Channel Development
New Product Strategies
Service Channel Development
Sales
Franchise Development
Operations
Accreditations & Certifications
Website/App Development
Other IT Development
Others
No of Tests in Lab Menu or Planned (Approx)
*
No of Beds
*
Technologies in Lab
*
Other Services Available
*
Online Presence
*
Website
App
Social Media Pages
Tick if Already Available
Accreditations & Certifications
*
NABL
NABH
ISO
CAP
Others
Not Available
Choose as per availability
No of Channel/B2B/Franchise Partners
*
Number of Pincodes with Home Service Availability
*
Current Monthly Revenue
Targeted Growth in 12 Months
*
10%
20%
30%
50%
75%
>=100%
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