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First Name:
Last Name:
Email:
Practice Name:
Address:
City:
ZIP:
State:
Phone:
How many current providers does your practice offer?
How many patients are seen per day?
Of those patients, how many are new?
How many prescriptions are submitted per day?
How many employees are assigned the task of pulling charts and preparing super bills?
What are your average monthly charges?
Do you have an in-house transcriptionist? Check if yes.
Do you use a transcription service? Check if yes.
What is the brand of your current EHR system?
What is your current Practice Management System?
Is your practice hospital owned?
What is the best time to contact your practice?
No preference
Morning 8-11am
Mid Day 11-1pm
Afternoon 1-5pm
Evening >5pm
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