Home Health Care Resource URL submission form

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Home Health Care Resource URL submission form

The home health care provider you explored does not have a web site, or an email address, listed with iCommerce.com. If you have the provider's web site address and an email address, please fill out the form below. We will update the search engine. If you have web site and email addresses of more than one hospital or facility, you may fill out numerous forms, or you can attach the list to an email and send the list to icommerce@sprintmail.com.

Home Health Care Provider URL listing request

The purpose of this form is to collect information from you about your home health care site or health care organization. If you are already listed with the iCommerce.com index, this form provides you the opportunity to perpetually update the listing information. If your site or organization is not currently listed with iCommerce.com you may submit this form for consideration.

This form is divided into the following sections:

URL/site information
Home health care description
Location
Form Submission

Fill out the information in each section as requested. Then at the end of the form supply your name and contact information, and submit the form. You will receive a confirmation message from us shortly.

We would like to have your feedback and your observation regarding our service:

SECTION A -- Home health care URL/site information

Please submit your site URL. It is important to include the http:// in #1

Enter the URL below (eg. http://www.myhomecare.com)

Enter a title for your URL (e.g. General Home Health Care is the leading hospital in City, USA)

Please enter a description of your home care organization site:

Choose one of the following that best describes your site:

Home Care Physician Nursing Hospital Other

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SECTION B -- Hospital description

We need to have a minimum amount of information about your organization:

Enter the primary email for your organization (eg. jdoe@myhomecare.com)

What is the category that best describes your hospital or organization?

If the category that best fits your organization is not listed above, please enter below:

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SECTION C -- Location

Please identify the residency country where your organization is located:

If your country is not listed above, please enter it below:

Please enter the State or Province, if applicable:

Please enter City:

Please enter Address:

Please enter Zip:

Please enter Phone:

Please enter any additional comments regarding your site:

How do you rate this Community Site:

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