Request for Development

Basic Info:

Medical Practice Name

Name

First Last

Phone

Project Details:

EHR system:

Project Name

Project description:

Project budget:

Desired integration features:

What is the desired timeline or deadline for completing the project?

Additional Information:

Are there any existing systems, processes, or infrastructure that the project needs to integrate with?

Need anything exported or Imported into or from Cerbo? What

File

Max. file size: 64 MB.

I understand and agree to the $75 hour dev rate and understand a Development Invoice will be sent to start the project. This submission approves a 1 hour development rate for project scoping. That is used for the project should the project move forward. * This is not refundable.(Required)

Yes

FxMedSupport

Request for Development

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