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WVHS Preferred Provider Intake Form

Thank you for contacting WVHS Preferred Providers regarding your solution. We have developed a data collection process that is focused on ideas, needs and vendor solutions for our member hospitals and non-acute care providers. The purpose of this process is to increase our awareness of valuable services and products that we can make available to our members. In order to evaluate your offering appropriately please complete the form in its entirety. We want you to participate and appreciate your involvement in our process. Be assured, all product and/or service details will be archived at the conclusion of the research and all competitors responses will remain anonymous and you have the option to discontinue with this process at any time.

Would you fee share, provide rebates/value adds to the member?:

Will you fee share with WVHS?:

Is this a West Virginia-based company?:

Is this company minority owned?:

Will you provide your services to small hospitals, and non-acute facilities?:

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