Blockchain Proof of Concept Request
Please complete this form as much as you can. This helps us expedite the process for a prompt and informative response. It may take a few days but we will get back to you as soon as possible. Feel free to contact us at info@emrify.com for any questions or comments. You may also subscribe at https://www.emrify.com/hit for the latest updates.
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Your Role / Title *
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Organization *
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Address *
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City, State, Country *
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Website
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Phone number
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Type of Health Stakeholder *
Which Electronic Health Record (EHR) do you use? *
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How do you rate your understanding of blockchain? *
Just heard of blockchain
Own some Bitcoin/Ether and can carry discussions
What is your goal for the blockchain Proof of Concept with Health Passport? *
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Anything else you'd like to add?
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A copy of your responses will be emailed to the address you provided.
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