Order ACG Software: Academic, Government or Non-Profit Use Only Please supply the requested information by email, fax, or mail to: ACG Project Phone: 410-955-9725 If your application is approved, we will mail a copy of the licensing agreement, together with additional instructions on how to proceed, to you at the address provided below. In the event your application is not approved or we have additional questions, we will contact you by phone or by email. You should expect to hear from us within two weeks from the date we receive your application/order form. Legal Caveats Please note that the requirements for academic, government or non-profit licensing include:
Dr. Mr. Mrs. Ms. (select) First Name: Middle Initial: Last Name: Position/Title: Company/Organization: Type of Address: Business Home (select) Address Line 1: Address Line 2: City: State/Province: Zip/Postal Code: Country: Telephone: Extension: Fax: E-mail: Please provide a brief statement detailing the following: 1. study objectives, data sources, time frames, and coding system(s) used 2. how you intend to use the ACG Case-Mix System software 3. funding sources 4. where and how you expect to present your results (so that we may verify that they will be made public) Please be prepared to answer additional questions and submit additional documentation if necessary. |