Name(Required) First Last Your Email(Required) Hospital Name(Required) Hospital State(Required)Select State BelowAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificExplanation of Discrepancy(Required)Please provide a hospital generated, practice management software report for last completed month. “Monthly summary report” of sorts is generally a good starting point. OR provide a hospital generated, practice management software report that specifically shows the data point in question so we can compare Pulse against.Max. file size: 128 MB.Other(Required) Please specify type(Required) Are there any PMS codes you would like to include or exclude from this data set? Date Range Default Custom Enter date details(Required) User Full Name(Required) First Last User Email(Required) Please describe the data reporting that you need in as much detail as possible.Priority Level(Required)Select Option BelowLowNormalHighUrgentDue Date(Required) MM slash DD slash YYYY Δ
