DEADLINE: JUNE 6

ENTER TO WIN
All applicants will be entered in a drawing for a FREE one year subscription to the HME Databank ($995 value)! See all the Databank has to offer at www.HMEDatabank.com.

BUSINESS TYPE

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* 1. What is your primary business type?

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* 2. For Home Respiratory Provider Only

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* 3. For Rehab Technology Provider Only

FINANCIALS

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* 4. What was your average annual rate of sales growth for the last two years?

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* 5. What was your average pre-tax profit margin over the last three years?

COMMUNITY INVOLVEMENT

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* 6. List membership, dates and leadership positions in trade groups. (i.e. AAHomecare, NYMEP, MED, VGM)

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* 7. List membership, dates and leadership positions in clinical associations. (i.e. NRRTS, AARC)

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* 8. List your three most significant community outreach activities in past year. Activity must be non-profit.

STAFFING

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* 9. Please List

QUALITY CONTROL

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* 10. Note the number of years accredited with the following accrediting organizations:

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* 11. Do you have a dedicated compliance officer? If no, leave blank.

LAST, BUT NOT LEAST

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* 12. In 100 words or less, tell us one thing that makes your company extraordinary.

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* 13. Contact Information

*PLEASE NOTE: All information is for judging purposes only and will be kept confidential.


BONUS: Winners will receive two FREE registrations to the 2019 HME News Business Summit in Cleveland, OH
www.hmesummit.com

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