SK&A Request for Quotation

SK&A - A Cegedim CompanySK&A, A Cegedim Company can provide you with the most current and accurate contact information for key hospital professionals.

Complete and submit the following for a
Free custom quotation from SK&A.
(Please don't contact American Hospital Directory for this information.)

FUNCTION(S) DESIRED:
[Hold down Control Key (Ctrl) and click to make multiple selections]

SELECTIONS:    
Site Addresses Only ($70/M)
Sites with Names and Titles  ($110/M)
Include Phone Numbers ($55/M)
Include Fax Numbers  ($75/M)
Include Email Addresses / deployment only  ($425/M)
Select by State(s): ($10/M)
Select by Bed Size: ($10/M)
FORMAT:    
CD-ROM ($100)
Email ($100)
FTP ($100)

SPECIAL INSTRUCTIONS:
(Special Instructions, Date Needed, Shipping Requirements, etc.)

REQUESTOR:
Forward quote by FAX / Telephone / E-mail

Your Name
Required
Your Title
 
Organization
 
Street Address

 
City, State, ZIP, Country
,  
Telephone Number
Required
FAX Number
 
e-mail address
Required

(There is no cost or obligation for a Quotation.)

Please note: There is a minimum order  of
sites ($400) or contact names ($500)

Phone and Fax Numbers are not included in a minimum order; they are charged separately.