The Professional Communications Group, Inc.
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Registration Form
 
Before you register you must first read the Terms and Conditions. Kindly fill-up the form given below and click "submit". All fields with asterix(*) are required . We will contact you as soon as possible in order to finalize the registration process .
BASIC INFORMATION:
    
First Name:       *
Middle Name:      
Last Name:       *
Birth Date:
            Month Day Year *
Email Address:       *
Tel.No.:       *
Fax.No.:       e.g. (604) 876-4433 or 604-876-4433.
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Note: Your Username must be unique .To check your username click on the button Minimum of 7 characters for Username and Password.
           Username and password can be a combination of letters, number and spaces.
 
Username:       *
 
             User Name is not yet validated
Password:       *
Confirm Password:       *
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If you forget your password.......
Security Question:      
Your Answer:       *
Four characters or more. Make sure your answer is memorable for you but hard for others to guess
 
Transcription File Format
 

Select transcription file format

     
     
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How many dictations you upload per day? 
How long is your dictation?

if the transcription is greater than 1 page a header will be added. Please select the pt information which you would like to appear on the headers.

Patient Name (required) Patient Health Number (PHN) Date of Birth Date of Visit
Note: Kindly check those fields that you will be dictating.
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Check the box if you wish to edit your transcriptions on-line and electronically sign them. If checked you will need to generate a password for electronic signature (E-signature)
E- Sign      
Confirm E-Sign      
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CLINIC/HOSPITAL AFFILIATION:
 
Send the invoice to *
Select Clinic/Hospital
If you choose myself. Please fill-up the required fields below if you choose myself
Country:
*
State/Province:
*
Postal Code:
*
City:
*
Address:
*
 
*
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SURVEY QUESTION:
How did you find our website?
Put your answer here:
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BILLING REFERENCES:
How do you want to receive your invoice? – please check all preferred methods
I will download the invoice myself.
Send me the invoice via email.
Before submitting this form, be sure that you have read and understood the
Terms and Conditions specified in this website.
I agree to the terms and conditions contained herein.

 

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