HIUG Membership Survey

(CRM/Siebel Users)

The Healthcare Industry User Group (HIUG) actively works to help our member institutions find and work with members from around the world with similar profiles. This survey will be used to populate and update the HIUG membership database, so please complete it to the best of your knowledge*. When complete, please email this document to:

*Institution Information and Contact Information are required information and necessary to assign initial login. You are strongly urged to fill out as much information as possible and keep profile information up-to-date.

Institution Information

Institution Name
Address Line 1
(Company headquarters)
Address Line 2
City
State/Province (Abbr.)
Country (Abbr.)
Postal Code
Timezone / Select a valueIDLWNTHawaiiAlaskaPacificArizonaMountainCentralEasternIndianaASTATWATGMTCETEETBTWASTCCTJSTACSGSTNZST
Main Company Homepage / (i.e. www.abc.edu or www.xyz.edu)
Public or Private / Select a ValuePublicPrivate
Geographic Region / Select a ValueWestCentralEastCanadaInternational
Company Type / Select a ValueHealthcare ProviderHealthcare PayerOther
Number of Members (Payers Only)
Products Offered (Payers Only) / (ie. Life, Dental, Vision)
Number of Employees
Number of Core Users
Number of Self-Service Users
Number of IT Support Individuals / (Only those who directly support your Oracle applications)
First Oracle Purchase / Select a Value198819891990199119921993199419951996199719981999200020012002200320042005
First Year live on Oracle / Select a Value198819891990199119921993199419951996199719981999200020012002200320042005

Contact Information

Key Contact – This is the primary person to contact in regards to your Oracle implementation at your company.

Key Contact Name
Key Contact Title
Key Contact Phone
Key Contact Email

Updates Contact – This is the person who the HIUG should contact to keep your membership profile current. This may be the same person as your key contact, or a staff member with detailed knowledge of your company’s implementation assigned this task.

Updates Contact Name
Updates Contact Title
Updates Contact Phone
Updates Contact Email

Vendor Contact - The Vendor contact may be you, a purchasing department person, or a special person setup to handle vendor inquiries. This person will be the only person our online vendor partners will be able to see from your company, giving you control of where you want that single point of contact to be. Sponsorship from vendors helps support the HIUG cause, so please provide some form of contact.

Vendor Contact Name
Vendor Contact Title
Vendor Contact Phone
Vendor Contact Email

Product Information

The following section asks you to let us know what products you have implemented and what your current projects are.

·  For any ‘Date’ row, please select the date when you went live on the version selected.

·  If there are products missing, or additional information you would like to provide, please enter it into the ‘NOTES/OTHER’ box at the bottom of the product information section.

·  In the ‘Development’ row, please enter product information for what your organization currently has in development (i.e. your next upgrade or implementation).

Oracle Siebel / Version / Database / Platform / Date
Implemented / Select a ValueNot PurchasedNot Implemented6.x7.07.57.77.88.08.1 / Select a ValueAllbaseDB2/400DB2/MVSDB2/UBD for AIXDB2/UnixInformixMS SQL ServerOracleSQLBaseSybaseOther / Select a ValueIBMDECHPINTEL PCSUNOther / Select a ValueBefore 2004Q1 2004Q2 2004Q3 2004Q4 2004Q1 2005Q2 2005Q3 2005Q4 2005Q1 2006Q2 2006Q3 2006Q4 2006Q1 2007Q2 2007Q3 2007Q4 2007Q1 2008Q2 2008Q3 2008Q4 2008
Development / Select a ValueNo Current ProjectUpg. PlanningImp. PlanningImp. 7.7Imp. 7.8Imp. 8.0Imp. 8.1Upg. to 7.7Upg. to 7.8Upg. to 8.0Upg. to 8.1 / Select a ValueAllbaseDB2/400DB2/MVSDB2/UBD for AIXDB2/UnixInformixMS SQL ServerOracleSQLBaseSybaseOther / Select a ValueIBMDECHPINTEL PCSUNOther / Select a ValueNo Date SetQ1 2004Q2 2004Q3 2004Q4 2004Q1 2005Q2 2005Q3 2005Q4 2005Q1 2006Q2 2006Q3 2006Q4 2006Q1 2007Q2 2007Q3 2007Q4 2007Q1 2008Q2 2008Q3 2008Q4 20082009 and beyond
MODULES LIVE (check all modules that you have installed or are installing):
Advisor
Analytics
Anywhere
Asset Management
Call Center
Call Center Anywhere
Oracle Contact Center Anywhere / CRM OnDemand
CTI
Data Quality
eCustomer
Email Response
eSales / eServices
Field Services
Financial Services
Forecasting
Handheld
Helpdesk Online / Product Configurator
Remote Client
Sales
Support
Territory Management
Universal Customer Master

Primary Product Contacts

On this page please list you primary functional and technical contacts for each of the major product areas. Ideally this should be the project manager or lead for these product areas. While we know that you may have additional contacts, please only list the primary contact.

NOTE: If you add someone to this list, please make sure that they also

appear on your initial user list (on the next page).

Functional Contact / Technical Contact
Oracle CRM/Siebel

Initial Members

Please list any employees who you think would benefit from being a HIUG member. This should include anyone who participates on your Oracle projects, your key contacts for each area, and anyone else who you think may be interested in getting involved with the HIUG. There is no cost associated with being a member of the HIUG so you can list as many employees as you would like. Members can always be added later by your company or by individuals through HIUG email support.

In addition, you can help your employees get involved by selecting any initial subscriptions they should have. You can select from our four interest group areas, and members may be subscribed to multiple groups. As we add them to the system, we will automatically subscribe them to that group so they can begin participating in discussions immediately. The user can easily remove an initial subscription at any time by logging in and updating their profile.

Name / Email Address / Financials / Materials / Human
Resources / Technology / EBS / CRM