Welcome to the CardioSmart TV Registration Form.

Thank you for your interest in participating in CardioSmart TV.

If you would like to preview a demo of CardioSmart TV, please click on the following link

Please complete all of the information in this form in regard to your practice.

When you complete all of the questions be sure to select the "Submit" button.

1. Practice Information (answer required)
Practice Name:
Practice Address:
Practice City:
Practice State:
Practice Zip Code:
Practice Country:
Practice Phone Number:
Practice Contact Person Name:
Practice Contact Person Email Address:
Number of Cardiologists In Practice:

CardioSmart TV must run on a flat screen TV which we will provide at no cost to your practice.

2. How many additional flat screen TVs will your practice require to implement CardioSmart TV?
None, we already have a flat screen TV
5 or more
Not sure

3. Will the programming from CardioSmart TV be running in one office location (i.e., address) or multiple office locations?
One office location
Multiple office locations
Not sure

4. Do you currently have internet streaming capabilities in your office(s)?
Not sure

5. Are there certain days when you see one specific type of cardiology patient?
Yes, please specify 
Not sure

6. Finally, what kind of clinical content would you like to see on CardioSmart TV?