EmailMeForm
Your Health Center Information:
Your Name:
*
First
Last
Your Title:
*
Health Center Name/Facility:
*
Your Email:
*
Your Phone:
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Your Capital Expansion Strategy:
Does your health center have plans to build new access points in the following timeframes?
Yes, in about 6 - 12 months
Yes, in about 13 – 18 months
Yes, in about 19 – 24 months
Yes in over 24 months
No
Other
Is your health center planning to acquire another clinic or service site in the following timeframes?
Yes, in about 6 - 12 months
Yes, in about 13 – 18 months
Yes, in about 19 – 24 months
Yes in over 24 months
No
Other
If your health center answered yes to either Question #1 or #2, has (or do you anticipate) your health center using grant funding (e.g., federal, state, foundation, other) for this project?
Yes
No
If your health center is acquiring another clinic or service site, do you anticipate having to replace old or outdated equipment?
Yes
No
Your Capital Expansion Needs:
If you answered yes to Question #4, how many exam rooms do you anticipate need to have equipment replaced?
1 – 3 rooms
4 – 6 rooms
Over 6 rooms
Other
If your health center is planning for capital or construction projects in the future, what type of equipment do you foresee having need for?
Exam tables
Integrated Wall Boards/Systems*
Cabinetry or casework
Scales
Vitals signs devices
Cardio/EKG devices
Flooring
Roofing
HVAC
Other
*thermometry, otoscopes, ophthalmoscope, etc.
Request Additional Resources:
Would you be interested in learning about a GPO consultative service that, while it costs a fee, will guarantee that discounted GPO contracts are used for capital and construction projects by working directly with your health centers’ project managers and architects and ensure ROI?
Yes
No
Are there any additional resources or more information related to capital and equipment that would be helpful?