Remember to use an Incogito/Private browser session when filling out this form. Contact Information First Name: Last Name: Email: Mobile Phone: Opportunity Cost Which days of the week are you open? M T W T F S S How many hours per day? What is the average Patient Visits (PV) per day? What is your average collections per PV? Step 1: Between what dates will you need a locum? Add a new date range Step 2: Define the days of the week you’ll need a locum. Day Of Week Daily Interval # of Visits Monday Full Day Half Day Tuesday Full Day Half Day Wednesday Full Day Half Day Thursday Full Day Half Day Friday Full Day Half Day Saturday Full Day Half Day Sunday Full Day Half Day Promo Code: Preview Opportunity Cost & Order Step 3: Opportunity Cost Calculation (Patients Visits per Week (Add PVs for M- T- W- TH- F- S- S)) X Average Collections per Visit ——————————- = Total Collections Per Week (or period of time they expect to need a Locum) Step 4: Preview Order Place Order
