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Please fill out the information below.
Company Name
Street Address
Street Address Line 2
City
State
Postal / Zip code
Primary Contact
First name
Last name
Position
Phone
Email
Property Details
Property Type
Number of Buildings/Locations
Total Drop/Bed Count
Provider Details
Current Provider
Average Monthly Service Bill
Are you under a current agreement?
Yes
No
Video/Cable Distribution
Is there video/cable distribution on site?
Yes
No
If YES, does the property own the rights to the onsite distribution?
Yes
No
Do you currently have set top boxes?
Yes
No
Are Local Network Affiliates (i.e. ABC, NBC, FOX, CW, PBS) available in your area?
Yes
No
Are you interested in an "In-House Channel" for your events and menus?
Yes
No
Would you be interested in a resident-friendly interactive service that works through their TV and allows for contact with family members outside of your facility?
Yes
No
Would you be interested in a system that improves cell phone performance in environments that typically impede quality cell phone usage?
Yes
No
Submit
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