Please fill out this form and a ClientSuite Specialist will contact you within two days with regard to:

  • A ClientSuite walkthrough over the phone
  • Pricing information
  • Any additional product information

We will use the information you provide only to respond to your request. Dataquest never shares customer information with third parties.

* Required fields

Prefix / First Name * / Last Name *

       

Title

Agency/Organization Name

Address

City, State and Postal Code

      

Phone *

  

Fax

E-mail *

Are you a Single County Authority?

Are you a Provider?

How many locations do you have?

Does your company have locations in more than one state?

What is the address of your headquarters?

How many employees do you have?

What is your facility type?

What types of Behavioral Health do you support?

How do you currently collect data?

If "Automated Software", which one?

Are you currently looking for new Client Management Billing Software?

If yes, what is your timeframe to purchase?

How did you hear about ClientSuite

What type of Internet connection do you have?

If none, do you have plans to get internet access?

Do you currently work with Medical Assistance?

How many clients do you serve annually?

What percentage of your revenue is from Private funding?

What percentage of your revenue is from Public funding?

What is your annual revenue range?

Yes, Id like to receive advance notice of your product updates and events via email.

For additional information, e-mail Sales@dataquestinc.com

ClientSuite enables you to reduce the amount of time it takes to compile reports, and document intake/assessment information.

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   Contact us: Dataquest    Olde Liberty Square, Suite 247    4807 Jonestown Road    Harrisburg, PA 17109    Phone: 1.877.306.1627    Fax: 717.545.8117


 
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