Intake form

Name *

Email address *

What type of service are you interested in?

Please select at least one option.

Healthcare professional licensing (DOH, DHA, MOH)

New facility licensing

License renewal & transfer

Primary source verification (Dataflow)

Recruitment services

Quality management

JAWDA & ADHICS compliance

DOH facility audit preparation

What is the current stage of your healthcare operation?

What is your preferred method of communication?

Do you have any specific compliance needs?

Please describe your workforce deployment requirements.

What is your expected timeline for commencing the services?

What is your budget range for these services?

Which service or services are you interested in?

Please select at least one option.

Healthcare professional licensing

Quality management consulting

Facility licensing support

Recruitment services

JAWDA compliance & data validation

ADHICS compliance & certification

Regulatory audit management

JCI accreditation support services

Additional questions or comments

Horizons Medi Solutions