RIMAGE MAMMOSMART EMPOWERMENT AWARD
MAMMOSMART ENTRY

MammoSmart Entry Form
   
Rimage and DatCard Systems are awarding two MammoSmart breast health screening systems to two deserving hospitals, clinics or imaging centers. Will yours be one of them? Please complete the following entry form and write a short essay about how your facility or patients will benefit from a MammoSmart system. You may receive a first-of-its-kind information on disc technology that customizes and personalizes breast health exams and information.

Please complete the following, or you may download a PDF here.
   
Name*
Title*
Institution*
Mailing Address*
Phone*
E-mail*
Are you the decision maker when it comes to purchasing mammography equipment?*
If no, do you know who is?
Purchasers Name
Institution
Address
Purchasers Phone
Purchasers E-mail
Do you currently use mammography in your facility?*
If yes, what type of equipment do you use (brand name, model)?
Do you also have a PACS system?*
If yes, make and model?
What media do you use for mammography output?*
CD/DVD   Film   Softcopy/Pacs/Workstation Monitor  
Are there other areas in your facility providing CD/DVD output for patients, referring physicans, etc?*
If yes, what areas?
What types of mammograms does your facility preform?*
Screening   Diagnostic   Biopsy   Other  
Do you currently create CD/DVDs for patients?*
How many mammograms does your facility perform per year?*
Are you reimbursed for providing patient exam information on disc?*
If yes, how much?
Prior to this award, had you heard of DatCard or MammoSmart?*
Yes - Datcard   Yes - MammoSmart   Yes - PACSCube  
No  
Prior to this award, had you heard of Rimage?*
How will your facility benefit from a MammoSmart system?*

No purchase necessary. Purchasing does not improve your chances of winning. Sweepstakes ends 11:59 p.m. CST January 31, 2008. Open to all legal U.S residents and must be used and installed in a medical facility located in the continental U.S. Void where prohibited by law. All federal, state and local regulations apply. One online entry per email account. Click here to view the full terms and conditions.

All fields with a * are required.