(504) 837-6266 Fax (504) 837-1174 / A Healthcare Shared Service
Organization Servicing the Needs of Our Members
ShareCor Vendor Application
I. COMPANY PROFILE
A. NAME
B. OWNERSHIP/CORPORATE DOCUMENTS MUST BE SUPPLIED
C. KEY PERSONNEL
D. BACKGROUND
1. TOTAL NUMBER OF YEARS IN BUSINESS
2. NUMBER OF YEARS IN HEALTHCARE
3. COMPANY HISTORY
E. FINANCIAL CONDITION
1. ANNUAL FINANCIAL REPORTS
2. BUSINESS PLAN
3. LETTER OF REFERENCE FROM COMPANY BANK/ AND CPA FIRM
F. AWARDS/ENDORSEMENTS/HONORS
G. LOCATION OF HEADQUARTERS AND LOUISIANA REGIONAL OFFICE(S)
H. COPIES OF LIABILITY COVERAGES
II. PRODUCT SUMMARY
A. PRODUCT(S)/SERVICE(S) PROPOSED
B. DESCRIPTION OF PRODUCT/SERVICE
C. WHAT NEED(S) PRODUCT/SERVICE SATISFIES
D. DISTINGUISHING CHARACTERISTICS OF PRODUCT/SERVICE
III. MARKET
A. MARKET SHARE
1. PRESENT (i.e. how many hospitals use your service? How many Louisiana hospitals use your service?)
2. POTENTIAL
3. GEOGRAPHICAL (i.e. do you have any geographical limitations?)
4. NATURE OF POTENTIAL USER (i.e. what size hospitals do you serve)
5. PROJECTED VOLUME FOR TYPICAL USER (i.e. what is the average cost per hospital)
B. COMPARISON WITH COMPETITIVE PRODUCT
1. COMPETITORS
2. QUALITY
3. PRICE
4. UNIQUENESS
5. WHY ARE YOU BETTER THAN THE COMPETITION?
IV. PERSONNEL
A. WHO WILL BE SHARECOR’S CONTACT
B. ORGANIZATIONAL REPORTING
C. WHO WILL BE THE CONTACT FOR HOSPITALS
V. SUPPORT/SYSTEM
WHO IN YOUR COMPANY WILL HANDLE/PROVIDE:
A. REPORTS (VOLUMES, DOLLARS, CONTACTS, DEALS, PROPOSALS, ETC.)
B. COMPLAINTS
C. TECHNICAL REQUIREMENTS/MAINTENANCE/PRODCEDURES
PLEASE PROVIDE US WITH:
SCHEDULE OF CLIENT CHARGES
COPY OF CLIENT PROPOSALS
VI. FINANCIAL PROJECTIONS
A. PRO-FORMAS (INCLUDING SUBSTANTIATION) (i.e. how many Louisiana hospitals do you expect to sign up the first year of the relationship)
B. MARKETING PLAN (SCHEDULES, DOLLARS, ETC.)
VII. BROCHURES, PAMPHLETS, MATERIALS, ETC.
VIII. REFERENCES: (PAST AND CURRENT) AND A LIST OF ALL LOUISIANA USERS
IX. OTHER
A. DISCOUNT OR SPECIAL PRICING TO LOUISIANA HOSPITALS?
B. MARKETING FEE PAID TO SHARECOR? (a monthly minimum will be paid to ShareCor for the term of the contract)
A Joint Venture of the Louisiana Hospital Association and the Metropolitan Hospital Council of New Orleans
2450 Severn Avenue · Suite 210 · Metairie, Louisiana 70001