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Scott Triggers Permission to use Copyrighted Material 2022 REV
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Scott Triggers PLLC Copyright permission Revised 01-06-2022

Requesting Permission to use Copyrighted Material


Name of Company/Medical Center_____________________

Contact Name_____________________________________


State, Zip ________________________________________ Country____________

Email and website_______________________________  


I am writing to ask your permission to utilize the Scott Triggers copyrighted tool (attached) for the following: (check all that apply)


_____  reprint   _____  photocopy ______Publication        (No charge)

_____ Digitize and incorporate into electronic medical records (EMR).  (Annual Fee applies for EMR integration up to 5 locations/hospitals in the same company). If more than 5 hospitals please contact Susan Scott at for a quote.


$1,000 annual fee payable to Susan M. Scott includes copyrighted tool integration into EMR such as EPIC, Cerner, MEDITECH, McKESSON, Allscripts, eClinicalWorks, NextGen, Athenahealth Healthland, Medsphere, QuadraMed, Sigmund, or others.


Included in the annual fee is the Scott Triggers® Solution resources and one hour of complimentary consulting time per online media for the purpose of strategic planning, and education. Three-year contracts available for 5% discount.




I have the authority to grant the permission requested herein and I hereby grant

______________________________________________________________________permission to use the above referenced material in the manner described.



 Susan M. Scott, CEO Scott Triggers PLLC

Copyright Holder's Signature  Date_______________ Expiration Date_______


I request that the credit line read: Scott Triggers®  Reprinted with permission Susan M. Scott