Full Name
Email
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Phone
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Practice Name
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Practice Specialty
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How Many Clinics/Providers Does The Practice Have?
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How Many Are Full Time?
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How Many Are Part Time?
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How Many Days Is The Practice Open During The Week?
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What Is Your Monthly Revenue?
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Please indicate monthly revenue per practice if there is more than one practice.
Do You Currently Have Your Own EMR/EHR?
If so, what EMR/EHR are you using?
Are You Currently Billing In-House Or Outsourced?
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