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Dear Pharmacist/Owner,

The purpose of this survey is to collect sufficient information to plan and execute the connection of the Digital Signage System in your pharmacy via your current network connection to our backend server.

Thank you for your time.

YOUR INFORMATION
Pharmacy Name
Owner's Name
Telephone Number
Email Address:

ADSL INFORMATION
Is there an ADSL line available in your pharmacy? Yes
No
If not, is there any other type of Internet connection available? Please give as much details as possible.

Who configures your ADSL router?
Company Name
Contact Name
Telephone Number
Email Address

NETWORK CABLING
Is there a network cable installed between the ADSL and the Digital Signage System? Yes
No
Unsure

Who do you use to install network cables?
Company Name
Contact Person
Telephone number
Email Address

OTHER OPTION

(If no existing network service can be used)
Would you be willing to buy a 3G solution: a 3G Router, SIM card and the smallest available Data Contract? Yes
No

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