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Incorporating Health Information Technology Into Workflow Redesign

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ATTACHMENT 2

PROPOSAL INTENT RESPONSE SHEET

RFP No. AHRQ-08-10036

Please review the attached request for proposal. Furnish the information requested below and return this page by August 15, 2008. Your expression of intent is not binding but will greatly assist us in planning for the proposal evaluation.

[ ] INTEND TO SUBMIT A PROPOSAL

[ ] DO NOT INTEND TO SUBMIT A PROPOSAL FOR THE FOLLOWING REASONS:

______________________________________________________________

[ ] I GRANT PERMISSION TO THE AGENCY FOR HEALTHCARE RESEARCH AND QUALITY, CONTRACTS OFFICE TO ADD THE CONTACT INFORMAION BELOW TO A BIDDERS LIST TO PROVIDE TO OTHER INTERESTED OFFERORS FOR TEAMING/SUBCONTRACING OPPORTUNITIES. (*MUST INCLUDE AUTHORIZED SIGNATURE)

COMPANY/INSTITUTION NAME & ADDRESS:

______________________________________________________________

*AUTHORIZED SIGNATURE: __________________________________

TYPED/PRINT NAME AND TITLE: ______________________________

DATE: ___________________

[ ] PLEASE DO NOT RELEASE THE CONTACT INFORMATION.

Please return to:

Agency for Healthcare Research and Quality
Division of Contracts Management
Attn: Linda Simpson, Contract Specialist
540 Gaither Road, Suite 4315
Rockville, Maryland 20850
Fax; 301-427-1740

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Current as of July 2008

The information on this page is archived and provided for reference purposes only.