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Titan Medical Solutions LLC
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Client Intake Form
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Name
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Email address
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What type of medical facility are you representing?
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Hospital
Surgery Center
Clinic
What services are you interested in?
Please select at least one option.
PEO Solutions
Staffing Solutions
LUNA App
Consultation Workflow Services
What is the size of your facility?
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Small (1-50 employees)
Medium (51-150 employees)
Large (151+ employees)
What challenges are you currently facing in your facility?
How did you hear about titan medical solutions LLC?
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Referral
Online Search
Social Media
Preferred method of contact
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Email
Phone
In-Person
Additional questions or comments
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