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1-2    3-5     6-10     11+   
Yes    No   



EHR Interest


How did you hear about GeniusDoc?

    Consultant               
    Friend/Referral       
    Magzine AD             
    News Article            
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    Trade Show             
    Other                        

Purchase Timeframe

    Immediate
    1-3 Months
    3-6 months
    6-12 months

Preferred Time for Demo

       
  Mon    Tue    Wed    Thu    Fri    Weekend

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