Request for QuotationInfection Prevention and Control Consultancy ServicesGeneral InformationHospital/Day Surgery Name:(required) Phone Number (include area code):(required) Address:(required) Contact DetailsContact Person’s Name:(required) Contact Person’s Title :(required) Contact Person’s Direct Phone Number :(required) Contact Person’s Email :(required) Quotation DetailsNumber of Operating Rooms :(required) Number of Procedure Rooms :(required) Number of Medical Overnight Beds :(required) Number of Surgical Overnight Beds :(required) Number of Operative Procedures per annum :(required) Number of Endoscopy Procedures per annum :(required) <strong>Surgical Specialties</strong> (Choose all applicable)(required) Endoscopy ENT Dental/Maxillifacial Gynae/IVF Ophthalmic Orthopaedic (excluding joint replacement) Orthopaedic (including joint replacement) Paediatrics Plastics/Cosmetic Vascular Other (Please list below) <strong>Medical Specialties</strong> (Choose all applicable)(required) Rehabilitation Mental Health Pain Management Other (Please list below) Other: <strong>Environmental Cleaning Services</strong>(required) In-house External Contractor <strong>Catering Services</strong>(required) In-house External Contractor Accrediting Agency:(required) Accreditation Month:(required) Closest Airport:(required) Additional Information: (for example: plans for expansion in the next two years, change and/or addition of new specialties Contact Us Δ
