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The following survey is to be completed by anyone scheduled to participate in the CareLogic software demonstration.
* 1. Please complete the following information:









2. Select the services  your organization provides:
Family services Substance abuse
Home health Residential services
Day treatment Outpatient mental health
Child Services MR/DD
School based services Employee assistance
Inpatient mental health Foster care
Partial hospitalization Crisis intervention
Other


3. Which departments from your organization will participate in the CareLogic software demonstration?
Executive IT
Clinical Intake
Billing HR
Finance Administrative
Implementation Team

4. Please rank in order of importance the following functionality requirements your organization would like to see during the demo.
Priority Important Non-essential

Priority Important Non-essential

Priority Important Non-essential

Priority Important Non-essential

Priority Important Non-essential

Priority Important Non-essential

Priority Important Non-essential

Priority Important Non-essential

Priority Important Non-essential

Priority Important Non-essential

Priority Important Non-essential

5. What is your annual operating budget?
$0-5M $5-10M $10-25M
$25-50M $50-250M $250M+
Other


6. How many full time employees does your organization have?

7. How many physical locations do you have?

8. What is your timeframe for selecting a new software package?
Within 90 days
90-180 days
180-360 days
No timeline presently
Other


9. Please list the key stakeholders for your group.





10. Please select your preference for software delivery.
ASP (Vendor hosted) Internal Undecided

11. Has a budget been allocated for this project?
Yes No

12. Please list the software packages you are currently using for accounting, electronic record and other critical applications.

13. How did you hear about Qualifacts?

14. Please describe any additional information that would be helpful for the Qualifacts staff to understand your needs and priorities.


 
 
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