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Medisoft Quote

For a FREE custom quote, please fill out the form below. Someone will get back to you within one business day.

This form is for NON-MEDISOFT USERS.

If you ARE currently using Medisoft, please click here to use this alternate form.

You can also call us toll-free at 1-877-265-4581 or email:

Your privacy is important to us. We WILL NOT sell your information to other parties. For more information please read our privacy statement.

Required fields are marked with a "*"

Title
Name*
Job Description*
Practice/Office Name
Specialty
Address
City, State, ZIP
Phone Number*
Fax Number
Email Address*

What software are you currently using for billing and/or EMR?

How many providers?

How many people will be using Medisoft concurrently?

Will you be using a scheduler?

Yes, I will

Would you like a live demo?

Yes, I would like a live demo

What billing method are you planning to use?

	Paper
	Billing Company
	Clearing House Specify house:
	Direct Module Specify modules:

Are you interested in Electronic Medical Records (EMR/HER)?

Yes, I am interested

Do any providers in the practice use a PDA
(PocketPC or Palm OS)?

Yes, there is PDA use

What other product(s) would you like pricing for?

	Appointment Call (Appointment reminder software)
	ReminderPro (Appointment reminder software)
	SOAPware EMR
	XLink (Interface software for Medisoft)

Additional comments (if any):

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Medisoft Software Tools

Medical Software Tools
is a registered D.B.A. of Southern Horizons, Inc. and is used
by MSR Technologies, Inc. with permission.
MSR Technologies, Inc. is solely responsible for all services provided under this D.B.A.
11808 North 56th Street, Suite A, Tampa, Florida 33617

Toll Free 1-877-265-4581

MSR Technologies, Inc. is an independent reseller of products. Medisoft is a registered trademark.
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