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Fill out the information below and a NetworkOmni Sales Representative will contact you shortly. Fields marked with a * are required.

Contact Info

*First Name:
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*Mailing Address 2:
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Are you a current NetworkOmni business customer?
Yes No
 
Please select your industry.

If Other, please specify
 
How would you like NetworkOmni to respond?
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Service Needs

Localization Translation

Please approximate your monthly word count
Less than 5000 5000 to 10000 Over 10000 Unknown

Please select the top 5 languages you will need translated.

Other:



Consulting Services

Please describe your consulting needs.

Please select the top 5 languages you will need interpreted

Other:



Over-thePhone Interpretation

Please approximate your monthly interpretation / translation minutes
Less than 1000 1000 to 10000 Over 10000 Unknown

Please select the top 5 languages you will need interpreted.

Other:




Video Remote Interpretation (American Sign Language & Spanish)

Please approximate your monthly interpretation minutes
Less than 1000 1000 to 5000 Over 5000 Unknown

Please select the languages you will need interpreted.
Does your facility have a high-speed internet connection?
Yes No
Does your organization currently use a videoconferencing service?
Yes No
Does your facility currently employ IT support staff?
Yes No

To serve you better, please indicate the departments in which you would like to use / install your video interpreting units (check all that apply):
Admissions Emergency room Examination room
Court/Hearing room Adminsitration office Social Services
Pharmacy Dianostic Testing Patient Education
OB-GYN Occupational Therapy Pediatrics
University Other
 

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