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FREE Optica Giveaway

Complete and submit the Assessment Form to enter the drawing to be held at the Chicago Mid-Winter meeting 2005 for a free Optica Intraoral Camera. Winner will be announced at the end of the meeting and will not have to be present to receive the prize. The prize is a complete Optica Intraoral Camera System that includes camera handpiece, docking station, and video cables. Winner will be responsible for all costs associated with installation, training, and applicable taxes. Existing Cieos clients are not eligible and no purchase is required. This prize can't be combined with any other offer, is non-transferable, and there is no cash alternative. The winner will be notified in writing. Offer void where prohibited.

Contact Information
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Preferred method of contact Telephone    Fax    Mail    E-mail
Your Practice
Practice Specialty General Perio
  Pediatric Oral Surgery
  Ortho Endo
Practice Type Solo Multi
  Group Clinic
Treatment Rooms Open   Closed   Bays   Total
Current Operations: Do you have...
Computers? How many?
Network? Type
Practice Mgmt Software? Name
Intraoral Camera? Name
Digital Radiography? Name
Digital Camera? Name
Patient Education? Name
Imaging Software? Name
Office Messaging? Name
Satellite Office(s)? How many?
Remote Access? Type
Tell us about your office culture
Team Style
Technology Interest
Clinical Computers When:
Digital Radiography When:
Intraoral Cameras When:
Inventory Tracking When:
Patient Education When:
Office Messaging When:
Image Software When:
Patient Entertainment When:
Lab Tracking When:
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