Lx Solutions Consulting Request

 
Fields marked with a * are required.

*First Name:
Middle Name:
*Last Name:
*Title:
*Organization Name:
*Phone:
*Email:
*Street Address:
*City
*State:
*Zip:
Next, we'd like to know a little more about your organization
*Organization Type (hospital, group practice, health system, multi-specialty clinics):
*How large is your company (number of beds, number of physicians, covered lives)?
Now let's discuss your consulting needs
Is there a particular situation or problem you are trying to address (limit 500 words):
*Is there a specific topic that you have already identified?






*When would you like to start (approximately)?
*Will your audience be physician-only or do you expect a mix of MD's and non-MD's?
*What is your desired outcome? (limit 500 words):
*How did you hear about us? (limit 500 words):