Appointment Report Request

Request Type:
Note: Only authorized personal may request reports. If you are unsure, please email to see if you qualify.
MM slash DD slash YYYY
*Note: Reports generally take 5-7 business days to process and be built. We will try our best to accommodate the date provided.

What fields needed on the report?

Patient information/visit:
How often does the report need to be run?

EHR Team Only

MM slash DD slash YYYY
Please enter your name