Form

Support Ticket Form

Please read.

If you need to activate services for an additional location or provider, please select the 'Account Change Request - Discuss with Customer Care Team' option.

If you need to deactivate services, please select the 'Account Change Request - Discuss with Customer Care Team' option.

If you'd like to submit a request to send out an e-blast, please travel to your Dashboard, then go to Tools, and then select the 'Request an e-blast' option.

You may also reach us through our live chat on our website, or our mainline 1 (800) 874-6601 (press 3, 4, 1 at the menu).

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We appreciate your partnership. Thank you for choosing us!

Company name

First name*

Last name*

Email*

Practice Management System*

Do you have a Problem, Request, or Question?*

Summarize your problem, request, or question*

What are you experiencing?
What errors or messages are you encountering?
What are you trying to configure?
What are you wanting to update?

Describe your problem, request, or question in more detail*

If reporting a problem, please provide examples (PatientID, ApptDateTime, Schedule, etc.)

Service Type

Select applicable service type