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2012
February
M
Medflow Meaningful Use Practice Survey
Medflow Meaningful Use Practice Survey
Medflow EHR & eRX Annual Practice Survey
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Practice Name:
Practice City & State:
Survey completed by:
Email address:
Telephone number:
Date completed:
Current Full-Time Providers
If you have more than 12 providers that are full time please add the remaining providers in question 10.
Name of Doctor
Medflow Software "log-in" name
Email Address
EMR Software Licenses Full Time Yes/No
Medflow eRX Licenses Full Time Yes/No
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7
8
9
10
11
12
Current Part-Time Providers
If you have more than 12 providers that are full time please add the remaining providers in question 10.
Please use the following definition of Part-time licenses
when filling out this survey.
Medflow EHR Part-Time Provider License - one license is required for each Ophthalmologist, Optometrist or DO working less than 16 hours per week
.
Name of doctor:
Medflow software "log-in" name:
Email address:
EMR Software licenses: part-time yes/no
Medflow eRX licenses: part-time yes/no
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10
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12
Additional Providers:
Please add any full or part time providers not added in questions 8&9 below.
Name of doctor:
Full-time or part-time:
Medflow Software"log-in" name:
Email address:
EMR Software Licenese: yes/no
Medflow eRX licenses yes/no
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5
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11
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