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how’re you? Primary Care Program
IDS Hospital Program

how’re you? Primary Care Program

Contact Information

Name of practice *

Primary contact name *

Email address *

Daytime phone number *

Fax number

Address of practice

City *

Province *

Postal code *

Practice Information

How many physicians work at your practice? *

What is the waiting room capacity of the practice? *

Avg. number of patients per day in the entire practice? *

Agreement

By submitting this form, I, the contact person listed above, understand that IDS Canada will be contacting me to discuss setting up an appointment for a site inspection and to discuss an installation date. I also understand the program is free and there are no charges for this service. All information provided is confidential and is used only for the purpose of implementing the IDS program. No information is shared with an external party. The display unit, poster frame, and digital poster remain the property of IDS Canada.

IDS Hospital Program

Contact Information

Name of the hospital *

Name of contact person *

Contact's title or position

Email address *

Daytime phone number *

Fax number

Hospital mailing address

City *

Province *

Postal code *

Hospital Information

Proposed number of waiting room locations (for units) *

Agreement

By submitting this form, I, the contact person listed above, understand that IDS Canada will be contacting me to discuss the service agreement and to arrange an installation date. I am aware that the program is free and there are no charges for this service. All information provided is confidential and is used only for the purpose of implementing the IDS program. No information is shared with an external party. The display unit remains the property of IDS Canada.

For further information regarding the IDS Hospital program, please contact us toll-free at 1-877-656-9996 or email info@idscanada.info

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Program Registration

Get started by choosing a program and completing the form.

Contact Information

Practice Information

Agreement

Contact Information

Hospital Information

Agreement

Find out more about our free patient information programs