Project Discovery Form

This form gives our team a clearer view of  current priorities, structure, project readiness, timeline, and challenges.

After its completion, we will develop an implementation plan that will help you imagine how we would transfer your pain point or strategic plans into a functional program. 

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First Name *
Last Name *
Email Address *
Job Title *
Organization Name *
What type of organization do you represent? *
Are you a critical decision-maker in your organization? *
Are you currently exploring or seeking implementation consulting services?
Clear selection
Which option best aligns with your organization’s current needs? *
How would you like to be engaged by Nautical Health? *
Required
What specific challenge or pain point is your organization hoping to solve with this engagement? *
On a scale of 1 to 5, how urgent is your organization's need for this project? *
Low Urgency
High Urgency
How would you describe your current data visibility? *
Please select your primary EMR (If applicable). 
Clear selection
What is the estimated timeline for initiating this project? *
What category best describes your target area? *
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