Vocera Reseller Profile Partner Application - North America Only

All Fields are required

Corporate Information

Name of Company:

Address:

City:

State/Province:

Zip/Postal Code:

Country:

Phone:

Fax:

Website:

President/Owner:

Email:

Primary Contact Name:

Primary Contact's Email Address:

Title:

Phone:

Sales Contact:

Title:

Email:

Phone:

Technical Contact:

Title:

Email:

Phone:

Number of branch/local offices:

Locations of the branch/local offices:

States, cities, regions where you focus your sales efforts:

Annual estimated revenues:

$ M

Top-five Primary Markets in priority order:

	% Business
1.
2.
3.
4.
5.

Number of current healthcare clients:

Product Information

What percent of your product sales consists of the following?
Hardware Software

Have you sold software applications that require the following activities:

Consultation with the end customer?
Yes       No

Analysis of the customer environment (site surveys)?
Yes       No

Design of the workflow/communication flow for the application?
Yes       No

If Yes, please list software applications you configured and installed.
Did your staff perform the configuration or was it outsourced?

Does your staff have small group facilitation skills?
Yes       No

If Yes, provide examples

Have you trained end users on the product/application you have installed?
Yes No
If Yes, describe the application and type of training

Have you trained end users using hands-on, small team environments in a clinical setting?
Yes No

Technical Information

Number of Voice Grade wireless LANs you have installed and supported
Would you be willing to share these references? Yes No

Provide a list of all wireless site survey tools that you use

Are you willing to provide us examples of your voice site surveys? Yes No

Number of Field Sales Representatives

Number of Wireless Sales/System Engineers

Number of Wireless LAN Engineers

Please list all wireless technical certifications

Please list all major technical certifications

What is your experience with IP Telephony and Telephony Integration?

What is your experience with software application integration?

Can you provide examples of application integration projects?

Check the type of support and service you offer your customers. Check all that apply
7 x 24 x 365 5 x 8 x 365 7 x 24 Other
Offer onsite?
Response Time?

Do you have a call-in Help Desk? Yes No
Do you have a network operating center? Yes No
Other support programs (please list all that apply)

To better understand your support and service program, please send us a generic copy of your program details and/or contract you provide to the end customer.

Do you work well in a hospital, clinical setting/nursing unit?
Yes       No
Years experience training end users on a software product?

Years experience working in a clinical setting, primarily acute care hospitals?

Training
RNs with minimum of three years clinical experience provide an excellent background for the Vocera solution. They are well received as trainers and provide understanding of the workflow of a hospital and role of clinical staff.

Is your staff comfortable around hospitals with noise, infection, intravenous infusions, etc.?
Yes       No

Do your trainers derive great satisfaction with end-user success of a product? Yes       No

Do your trainers have excellent communication skills?
Yes       No

Clinical Information

Our company sells the following clinical software applications:

Types of clinical roles that use the software application:

Typical setting for software application use:

For each software application, note if they include any of the following:

a. Workflow assessment (describe):

b. End-user training (describe type of training, length of training sessions, typical training engagement):

c. End-user consultation (describe):

d. Software configuration (describe):

e. Database development (describe type and data gathering process):

List and describe each role involved in your software application deployment. For each role, state how many individuals fill these roles:

Role	Major Responsibilities	Number of Individuals

Vocera Authorizations

Vocera Communications requires individuals to be authorized in the following categories. Details of the Authorization Program is contained in the Vocera Partner Program Overview.

Please list who you would consider to be your designated Vocera Representatives within your organization:
Vocera Practice Manager(s)
Vocera End-user Trainer(s)
Vocera Network Installer(s)

I acknowledge that by submitting this request form for information I may be contacted by a representative of Vocera Communications via telephone or email.