What does my order include? Insync will provide you with the tools to facilitate your surveys online. At an additional cost of $50, we can also provide you with a PDF copy of the survey for you to print; in this case, you can use both methods to maximise patient participation. Benefits of doing your surveys online: a quicker report turnover time (no more than 48 hours) get your results live on the interactive portal beneficial for the environment You'll also receive: poster template, QR code poster, patient information form, clinic checklist survey drop box and reply paid envelope to return completed paper surveys (if paper forms have been selected) management of the data entry and analysis process dashboard summary report with identified areas for improvement and recommended actions online interactive report for self-analysis 1. Survey administration method Please note that the selection of 'online and paper' incurs an additional cost of $50.How will you administer the surveys?* Online only Online and paper (online survey via URL and QR code, and paper) 2. Annual subscription selection The survey will run for a 3 month period, an annual subscription is available should you want to run a continuous survey. Annual subscriptions are charged at $50 which includes a quarterly scorecard report. Would you like an annual subscription?Annual subscription?* Yes No 3. Calculate the number of FTE clinicians in your clinic To calculate your number of FTEs, divide the total number of clinician hours worked per week by 37 and round up to the nearest whole number. You can use our quick calculator on the right side of this page to determine your clinic's FTE number. Select the number of FTE clinicians below. For 21+ FTE pricing please contact us.Number of FTE's*Please select1 FTE in practice2 FTE in practice3 FTE in practice4 FTE in practice5 FTE in practice6 FTE in practice7 FTE in practice8 FTE in practice9 FTE in practice10 FTE in practice11 FTE in practice12 FTE in practice13 FTE in practice14 FTE in practice15 FTE in practice16 FTE in practice17 FTE in practice18 FTE in practice19 FTE in practice20 FTE in practiceNumber of FTE's*Please select1 FTE in practice2 FTE in practice3 FTE in practice4 FTE in practice5 FTE in practice6 FTE in practice7 FTE in practice8 FTE in practice9 FTE in practice10 FTE in practice11 FTE in practice12 FTE in practice13 FTE in practice14 FTE in practice15 FTE in practice16 FTE in practice17 FTE in practice18 FTE in practice19 FTE in practice20 FTE in practiceNumber of FTE's*Please select1 FTE in practice2 FTE in practice3 FTE in practice4 FTE in practice5 FTE in practice6 FTE in practice7 FTE in practice8 FTE in practice9 FTE in practice10 FTE in practice11 FTE in practice12 FTE in practice13 FTE in practice14 FTE in practice15 FTE in practice16 FTE in practice17 FTE in practice18 FTE in practice19 FTE in practice20 FTE in practiceNumber of FTE's*Please select1 FTE in practice2 FTE in practice3 FTE in practice4 FTE in practice5 FTE in practice6 FTE in practice7 FTE in practice8 FTE in practice9 FTE in practice10 FTE in practice11 FTE in practice12 FTE in practice13 FTE in practice14 FTE in practice15 FTE in practice16 FTE in practice17 FTE in practice18 FTE in practice19 FTE in practice20 FTE in practiceSubtotal $ 0.00 GST $ 0.00 Total Due (inc GST): $ 0.00 4. Fill in your clinic detailsClinic Name*Clinic Address*Suburb*State*Please select...VICNSWWASAQLDNTTASACTPostcode*Primary Contact First Name*Primary Contact Last Name*Phone Clinic*Phone MobileEmail Address* Enter Email Confirm Email How did you hear about us?Please selectReferred by another hearing clinicReferred by a colleague or peerExisting Insync clientInsync website or Google searchLinkedInIndustry event, publication, or associationOther (please specify)Other 5. Payment MethodPayment Method* Credit Card (VISA or Mastercard) EFT Bank details for EFT: Account Name: Insync Surveys Pty Ltd ABN: 58 108 768 598 BSB: 182 222 Account No: 26719 5691 Credit Card* MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month010203040506070809101112 Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name Acknowledgement* I acknowledge that our surveys will be printed in accordance with Insync printing instructions (to be sent with survey materials) to avoid delayed turnaround times. Join mailing list Please tick box if you do not wish to subscribe to our Insync Insights. Order IDCAPTCHA