Request for Development

Basic Info:

Medical Practice Name

Name

First Last

Phone

Project Details:

Request for development type(Required)

General Request - No Timeline

Request for development - Special Project

General Request are not followed up with proposal schedules

I understand and agree to the $95 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. * This is not refundable.(Required)

Yes

EHR system:

Project Name

Is this an Integration into New Applications

Yes

List

Application Name

Application URL

Development Doc URL

Project description:

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.

When Do you need the Project finished

Do you need a Rush on starting? Development schedule is currently starting 6 weeks from this date.

Yes

Rush Fee - if the project needs to be started prior to our internal start date there will be a rush fee of $500-$2,500. The amount of the rush fee will depend on the urgency of the project Timeline in relation to our other deliverables.

I understand

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Request for Development

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