TMA Practice Consulting RFP

Request a Service Proposal

Primary Service Area(s):

Practice Name:

Physician Name(s):  
Are You/Is the Physician a TMA Member? 
Contact Name:    
Contact Phone Number (please include dashes):   
Contact E-Mail Address:   
Practice Location (city, state):   
More Than One Practice Location?

Number of Physicians and Nonphysician Practitioners:

How Do PAs or NPs Bill for Their Services?
Number of Staff Members:
(excluding physicians and nonphysician practitioners)
Practice Manager/Administrator
Front Office (check-in, check-out, schedulers, phones)
Billing and Insurance
Clinical Assistants
EMR and Practice Management Software Name(s):   
Medical Records:
How Did You Hear About Our Services?   
Briefly Describe Your Main Concern(s).  



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