SIOTEQ Hospital Management System (HMS) Waitlist - SIOTEQ

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SIOTEQ Hospital Management System (HMS) Waitlist

Thank you for your interest in onboarding onto SIOTEQ’s Hospital Management System (HMS) software. Please fill out the following form to help us assess your readiness and tailor our services to your needs.

HMS Waitlist

Hospital Information

Hospital Name *

Hospital Type *

Address *

City *

State/Province *

Country *

Contact Person *

Designation *

Email *

Phone *

Is your hospital duly registered? *

Current System & Readiness

Do you currently use any hospital management software? *

Please Specify Software *

What are the major challenges you face with your current system? *

Do you have an IT team to support software implementation? *

What is your expected timeline for implementation? *

Hospital Capacity & Services

Number of Beds *

Number of Departments *

Number of Daily Patients (Approximate): *

Key Services Provided *

Outpatient

Inpatient

Emergency Services

Pharmacy

Laboratory

Radiology

OtherOther

Software Requirements & Preferences

Which features are most critical for your hospital? *

Patient Registration & Records Management

Appointment Scheduling

Billing & Invoicing

Inventory & Pharmacy Management

Laboratory & Radiology Integration

Doctor/Nurse Workflow Automation

Telemedicine

Insurance & Claims Processing

Custom Reporting & Analytics

OtherOther

What is your estimated budget for an HMS solution? *

< N1,000,000

N2,000,000 –N5,000,000

N5,000,000 –N8,000,000

N10,000,000

Are you open to a subscription-based model? *

Are there any funding or grant opportunities available to support the implementation? *

Additional Comments & Expectations

Please share any additional information or specific requirements you may have

Select major operational problems facing your clinic/Hospital (Select all that apply) *

Inadequate Funding

Poor Infrastructure

Shortage of Medical Personnel

Insufficient Medical Equipment

Unreliable Power Supply

Overcrowding

Poor Record Keeping & Data Management

Weak Emergency Response Systems

Inadequate Drug Supply & Fake Medications

OtherOther

Would you be willing to attend any of our upcoming SioTeq Special Events? We’d love to have you join us and be part of the experience! *

Would you like us to contact you with more information or updates? *

Would you be open to us reaching out to you with more details or future updates? *

Please select the best way(s) for us to reach you *

Phone Call

SMS/Text Message

Email

WhatsApp

Other (please specify)

Agreement & Submission *

By submitting this form, you express interest in onboarding SIOTEQ's HMS software and agree to be contacted by our team for further discussions.

Full Name *

Full Name

First Name

First Name

Last Name

Last Name

Date

Position/Role *

If you are human, leave this field blank.

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