Let's Understand Your Process!

Name:
Position:
Facility:
Phone:
E-Mail:

How are you currently processing requests?
In-House	Vendor	Hybrid

What service or services are you interested in?
Claims File Scanning & Copying	Medical Record Archiving
Medical Record Scanning & Copying	Internal Copying
Medical Authorization Copying	IME Copying
Analog Film Copying	Field Copying
Film Copying from a PACS System	Subpoena Copying
X-Ray Copying	Site-to-Site Copying
MRI Copying	Same Day Response

I am looking to implement a solution that...

Please select the most appropriate response... provides my department with professional, skilled and HIPAA trained staff that we can rely on! puts revenue back into my department's budget! allows my staff to focus on other mission critical tasks within my department! provides my department with the resources to track all requests processed by my facility! eliminates challenges my department faces when handling the volume of requests it receives!

I would like to...
Please select the most appropriate response... schedule a conference call with decision makers. schedule an in-person meeting with decision makers. schedule a demo of eRequest and/or eDocs.

When would you like to be contacted?
Please select the best time for you... Early Morning Mid Morning Early Afternoon Late Afternoon

Additional details...