Let's Connect - HL7 interface request
Please submit the following information to initiate all HL7 interfaces.
* Required
Email
*
Your email
Date of Request
MM
/
DD
/
YYYY
Site Name
Your answer
Site Contact, Title and Email
Your answer
Site EMR Vendor
Choose
Point Click Care
MatrixCare
Other
If "Other", please list
Your answer
Site EMR Rep name and email
Your answer
Interfaced System
Radiology
Clear selection
Interface type
Order and Results
Results only
Clear selection
Please note that there may be a cost associated with this interface through your EMR vendor. CMMS will assist with facilitating the project with the information provided above. Project timelines may vary.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Corridor Mobile Medical Services.
Report Abuse
Forms
