XGL ENQUIRY FORM

HEALTHCARE ENQUIRY FORM

Simply fill-in and press SEND

Just a short form that should take a couple of minutes of your time to fill out.
We've made it easy for you to cut n paste blocks of text such as address, business requirements etc.
(Mandatory fields are headed in red, helpful in green and optional in grey )

Help us not to overload you with information. To receive the appropriate Infopack :
1 Tick specific products and services below and
2 Include your Business Requirements and what it is you're trying to replace / achieve (further down)

Through what media did you find us?
eg Magazine (and month), Search Engine name? XGL Flyer (ref please) Site with our WEBlink

Which Software Package products are you interested in at this time?
PATIENT COMPLAINTS & ENQUIRY MANAGEMENT System:

STAFF TRAINING NEEDS MANAGEMENT System

QUALITY PROCESS MANAGEMENT System:

PATIENT WAITING LIST ANALYSIS System:

Which version?:
Enterprise version: - operators, supervisors, managers in multi teams/sites on WANs/LANs/International
Standard version: - medium sized organisations, single team structure
Small version: - for stand-alone or small business workgroup

Which Service are you interested in at this time?
PROGRAMMING

ANALYSIS-DESIGN

CONSULTANCY

SKILLS TRAINING

DESKTOP SUPPORT

Title, Forename & Surname:

Your Job Position and Department

Your Organisation Name:

No of Employees?:
Less than 15 15-74 75-200 201-500 Greater than 500

Address Lines :

PostCode :

Your E-mail address :

Phone and Fax numbers :

Timescale (no.of months) in which you're looking to implement a solution:

What Operating System & network are you running? (eg win98, NT, 2000, XP & Netware)

Your Business Requirements of a new system: ( I.E. MUST SOLVE / EASE THESE PROBLEMS )

What existing system are you looking to replace (eg paperbased, software name, in-house developed)

What does your organisation do? (if not obvious from organisation name)

Specific business or technical questions you might want answered now :

Your appraisal of our web site :

HAVE YOU COMPLETED ALL MANDATORY FIELDS (SHOWN IN RED) ABOVE for a speedier response

Thanks for your interest in XGL Products or services.
Your enquiry will be processed within a few days.
Information Desk Team