Call Center Inquiry

 

COMPANY CONTACT

Company:  Company Type:
Name: E-mail:
Phone:  Fax:

DOCUMENTS REQUESTED (please check all that apply)

Fee Estimate & Service Description
    (define assumptions below)		 Call Center Brochure
Retention Services
Experience Metrics
 Other  
 

FEE ESTIMATE ASSUMPTIONS

Disease:

Phase:

Rescue Project? 


Sites
Number of US Sites:    Number of OUS Sites:     
Countries:

Duration
Call center in operation (months):    Study Start Date:

Media (check all that apply)
TV
Radio		 Direct Mail
Public Relations		 Web
Other 
Advertising Start Date:



Enrollment
Total # of patients needed for study:    Remaining # of patients needed:

Calls
Total # of calls expected:    Calls to pass pre-screening:    Minutes per call:

Languages:

English % of Calls:
Spanish % of Calls:
French Canadian % of Calls:

 

Nurse Operators: 

Number of Calls: 

 Minutes per call:

Interactive Voice Response System (IVRS): 

 Minutes per call:

 

Script Development:  Appointment Scheduling: 
Warm Transfers:  Referral Tracking: 
Web Screener:
 (Integrates w/ existing web site)  		Fulfillment: 
Presentation at Investigator Meeting:  

 

COMMENTS: