Universal Hospital Services (UHS)

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Amman
Beirut
Cairo
Dubai
Boston


Services

Please complete the following form in order to let us know about your facility. Fields marked with the sign "

" must be filled. Provide most recent statistics; estimate if actual figures are not available. When you complete this form click "Next" and go to "Services Required" form.

	Hospital name :
	Owner(s) :
	Type of hospital :
	Year opened :
	City :
	Country :
	Contact person(s) :
	Telephone No. :
	Fax No. :
	E-mail :
	Postal address :

	Inpatient bed count :		Beds
	Number of outpatient clinics :		Clinics
	Number of emergency places :		Places
	Number of delivery rooms :		Rooms
	Number of operating rooms :		O.R's
	Number of radiography rooms :		Rooms
	Total site area :		Sq.Meters
	Built-up area :		Sq.Meters

	Occupancy rate :		%
	Total Admissions :		Per Year
	Outpatient visits :		Visits/Year
	Emergency attendances :		Attendances/Year
	Deliveries :		Cases/Year
	Radiographic examinations :		Exams/Year
	Pathology tests :		Tests/Year
	Catering :		Meals/Peak Period
	Laundry :		Kg.Daily
	C.S.S.D :		Cubic Meters Daily

	Year hospital was designed :
	Designed by :
	Year(s) hospital was constructed :
	Contractors(names):
	Skeleton :
	Finishes :
	Electrical :
	Mechanical :
	Medical gases :
	Medical equipment :
	Other (specify) :
	Supervision over construction was done by :
	Building & engineering (firm) :
	Construction management :
	Medical equipment(if Package dealer) :
	Other (specify) :
	Maintenance works by :
	Building & engineering (firm) :
	Medical equipment :
	Other (specify) :


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