EMR integration request

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Company name *

Company type

First name *

Last name *

Title

Email *

Address *

Zip *

City *

State

Country *

Region *

Phone *

Website

Choose product *

Product serial number (SN) * Where do I get this number? Look for "SN" followed by 5-7 digits printed on your device. Do not include any letters or symbols.

Firmware version Main menu / Configuration / Device Information

PC software version for example "EasyWare 2.9.2"

Description *

Attach your logfiles, printscreens or photos

Accepted file types.log / .jpg / .png / .gif

Max. file size10 MB

Max. 3 filesper upload

Browse file

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