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Medical Records Request
Home
Services
Records Storage
Media & Tape Vaulting
Medical Record Custodian
Microfilm Scanning
Document Scan Imaging
Secure Shredding
Online Services
Why Choose Us
Making The Switch
About Us
Careers
Get A Quote
Contact Us
Medical Records Request
Scan Imaging Project Information:
Scan Imaging Capture Form
Customer Contact Information
Company Name:
*
Contact Name:
*
Title:
Address:
Address:
Address line 1
Address line 1
Address line 2
Address line 2
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Phone Number:
*
Email Address:
*
About the Project
Project completion date (If Applicable):
Type of engagement:
One time project
Day Forward (ongoing)
Type of Records: (Example: Medical Records, Patient Files, Client Folders, Etc.)
Medical Records
Client Folders
Vendor Folders
Other
Other
Size of the Document
8.5” x 11” or 8.5” x 14”
Other (Small Sized, 11” x 15”, Etc.)
Other (Small Sized, 11” x 15”, Etc.)
Color Required
Option 1
Volumes:
Estimated Number of Files:
Estimated Number of Boxes:
Average Pages per File or Box:
Double Sided
No
Yes. Estimated Percentage Double Sided:
Yes. Estimated Percentage Double Sided:
Technical Requirements
LIGHT
Lightly fastened documents (less than 1 fastener every 20-25 pages) 99% bond paper, 99% letter size and less than 1% require repair or mounting to the carrier sheets. Less than 5 manual sorts Less than 1% out sort (non-scan documents)
MEDIUM
Moderately fastened documents (less than 1 fastener every 5 pages) 99% bond paper, remaining office type documents.95% letter size and less than 1% require repair or mounting to the carrier sheets. Between 5 to 10 manual sorts. Less than 1% out sort (non-scan documents).
HEAVY
Heavily fastened documents (more than 1 fastener every 5 pages) Including documents contained in envelopes which require opening and extracting: 80% bond paper, remaining office type documents; 80% letter size and less than 2% require repair or mounting to the carrier sheets. All wide format documents will be considered heavy preparation.
Reassembly:
None Required
Simple
Full Assembly
Image Output:
Multipage TIF
Multipage PDF
Searchable PDF
PDFA
Release Method
CD/DVD
USB
External Hard Drive
Access (How often are these files accessed?):
Daily
Weekly
Monthly
Annually
Other
Other
Retention Policy (How long do these files need to be kept?):
5 Years
6 Years
7 Years
10 Years
Indenfinitely
Other
Other
Indexing: Index Field Name (Information on top of the file tab). Example: (Patient Name, D.O.B. Year of Chart, Month of File, Client Name, Vendor Name, Etc.)
After the project has been completed:
Return to Customer
Destroy
Store with Data Storage Centers
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