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Smartbox TV System Survey

General
Property Name
Property Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Primary Contact
Name*
First Last
Title
Contact Email*
Contact Phone*
Contact Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Property Details
Property Type*
Hospitality, Healthcare, Commercial Private/Public, Government, Other
Number of Buildings on Site
Number of Locations
Most Important Channels
Drop Count or Total Bed Count*
Provider Details
Current Video Services Provider
Are you under a current agreement?
- Yes
- No
Current average monthly service bill?
Video/Cable Distribution
Is there video/cable distribution on site?
- Yes
- No
If YES, does the property own the rights to the onsite distribution?
- Yes
- No
Do you currently have set top boxes?
- Yes
- No
Are Local Network Affiliates (i.e. ABC, NBC, FOX, CW, PBS) available in your area?
- Yes
- No
Are you interested in an "In-House Channel" for your events and menus?
- Yes
- No
Bonus
Would you be interested in a resident-friendly interactive service that works through their TV and allows for contact with family members outside of your facility?
- Yes
- No
Would you be interested in a system that improves cell phone performance in environments that typically impede quality cell phone usage?
- Yes
- No
Qualifications for two months of free programming (eligible property must be able to receive over the air local networks and have a minimum of 100 beds or drops) good through December 31, 2021.
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Smartbox TV System Survey

General

Primary Contact

Property Details

Provider Details

Video/Cable Distribution

Bonus

Qualifications for two months of free programming (eligible property must be able to receive over the air local networks and have a minimum of 100 beds or drops) good through December 31, 2021.