Scriptacom Account Registration
Thank you for your interest in our medical transcription service [Scriptacom Solutions]. To set up an account, please fill out the information below.
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Organization
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Contact Persons Name
Title
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Address 1
Address 2
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City
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State
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Postal Code
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Business Phone
Fax
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Email Address
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Is there more than one person dictating?
Yes
No
Please list person or persons dictating.
Name
Name
Name
Name
Name
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Will you be using the phone to dictate or a digital recorder?
Phone
Digital Recorder
Both
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Have you used a Web-based dictation service before?
Yes
No
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If not, how do you currently handle your dictations?
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Charges for dictation are based on a 65 character line with space. The cost is 12 cents per line. Do you accept these charges?
Yes
No
Do you have any Special Requirements or Additional Dictators? If so, please list them here.
Please add sample transcripts.
Please add physician referral list.
Please add physician letterhead.
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