Electronic Medical Records-Paperless Office-Electronic Medical Records- Document Management

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Describe your electronic medical records software needs by completing the form below

1)	For what type of medical practice are you planning to obtain EMR software? [required]

Primary care
Specialty (please specify):
Hospital
Dental
Physical therapy/chiropractic
Other (please specify):

Please Note: Our suppliers are unable to provide solutions to Acupuncturists or Home Health Care Providers.

2)	How many licensed physicians will use this EMR system? [required]

1-2
3-5
6-10
11-25
25+

3)	How many locations will use this EMR system? [required]

1
2
3-4
5+

4)	Which practice functions are you looking to address with EMR software? [required]

Record management and reporting
Interoperability with other medical practices/facilities
Automated prescription writing
Automated prompts/reminders
Electronic-tablet based charts
Other (please specify)

5)	When would you like an EMR system installed? [required]

Immediately
Within two months
Between two and four months
More than four months

6)	What is the five digit ZIP code for your office location? [required]

What is your e-mail address? [required]

Why we need your email address

8)	Other than price, what is most important to you when selecting medical software?

Features and functionality
Ease of use
Customization
Compatibility with palm handheld or PDA
Service (installation, training and support)
Other (please specify):

9)	Please briefly describe any additional requirements you have for EMR software.

Serious requests only! Up to 5 electronic medical records software companies will follow up with you directly about your needs. Please submit this request only if you are serious about purchasing.

You're almost done! If you have answered all of the required questions above, click the "Continue" button below to finish and send your request.

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