Telemedicine Registry and Evaluation in India -Registration form
Please enlist yourself as a Telemedicine solution provider (platform/application/devices) for doctors/hospitals/patients in India.

Kindly note that the information will only be used to promote Telemedicine/TeleHealth/Digital Health in India by well known and unbiased healthcare associations in India.

We will get in touch with you for more detailed evaluation of the solution after your response to this preliminary inquiry.

Regards
Alliance for Telemedicine Registry and Evaluation
 
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Name of Company *
Name of Product
Website Address URL *
Name of Contact Person *
Contact Mobile Number *
Contact email id *
In Operation Since mm/yy *
Type of telemedicine services enabled by your solution *
Required
What is the business model for the telemed solution? *
Required
Mode of Interaction Supported by Solution (tick all options available) *
Required
Type of Solution *
Required
What type of interactivity does your solution provide to doctors/patients? *
Required
What are the clinical and technical capabilities of your solution for the doctor? (tick all that apply) *
Required
What are the capabilities of solution for capture of information from patient for a consultation? *
Required
What are the type of medical consultations available? *
Required
Does your solution meet the Telemedicine Practice Guidelines (TPG) announced by Board Of Governors in supersession of MCI available at https://www.mohfw.gov.in/pdf/Telemedicine.pdf *
Required
Does your solution meet the IT Security and Data Protection requirements laws and requirements of healthcare IT? *
Required
Please state Healthcare IT standards used in your solution? *
Required
Type of IT Infrastructure required for your solution at patient and provider end? *
Required
Number of Healthcare Workers (doctors, nurses, paramedics, technicians) using Solution or Expected to Use Daily *
Any further information about your solution and any feedback/comments? *
Would you like to be listed in a repository of telemed providers of India? *
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