Site Survey

  • Products of Interest

  • Tell Us About Your Site

  • How many external beam treatment machines, e.g., linacs, does your site have?
  • Please select from the list.
  • Institution Name / Billing Information

  • Clinical and Administrative Contacts

  • The Primary Clinical Contact is the principal lead for coordinating .decimal software installation, facilitating online training schedules, and working with our representatives to ensure proper and timely implementation Primary Clinical Contacts agree to make themselves reasonably available to .decimal representatives during this process.
  • Shipping Information

    Note: You may enter "same" for fields that are the same as previously entered for Institution / Billing Info.
  • Accounts Payable

  • Information Technology / Information Security

  • Software Users

  • For HIPAA purposes, individual software logins are required. Please provide the following information for all personnel who require access to decimal applications (e.g., "p.d" software).
  • Additional Contacts for Order Confirmations

    These contacts will receive order confirmation notices.
  • TPS and Linac Information

    If you have more than two applicable TPS systems or three applicable linacs, you can enter the additional information in the notes section at the end.
  • Note 1. Machine name has to match the TPS name.
  • Note 2. If you have multiple machines, please contact .decimal for proper set up.
  • Required for Bolus ECT

    In order for us to properly setup your account, we must obtain the energy and its respective R90 depths for your machines.
  • decimal3D Setup Parameters

    If you are a decimal3D customer, please visit the following link to enter required parameters to ensure proper setup of your hand-held 3D scanner.
  • Please go to this form to enter parameters required to complete your decimal3D configuration.
  • Survey Wrap Up

    Any additional things you like to share, use this section.
  • This field is for validation purposes and should be left unchanged.