INQUIRY DATABASE





















  PUMC.COM

 

 
Description: This format is set up to not only send messages to the doctor’s office via e-mail, but, capture all messages into a special client database hosted by PUMC.  This database is set up in Excel for ease in importing into most standard databases for continual use by the doctor’s office for routine communications.  The information is designed to conform to the HIPAA regulations and obtains the approval of the inquirer on which methods they desire to be communicated.
 

Cost: 
$750 design $150 monthly maintenance
 
Click on "sample e-mail to see what the information on this form looks like when it
 comes in and click on "database" to see the database that gathers information.
Sample E-mail Database Information
* required fields
First Name: *
Last Name: *
Address 1:
Address 2:
City:
State:
Zip Code: *
Phone:
E-mail: *
Method To
Contact Me By:
Yes, please contact me and put me on your mailing list.
I can be reached through any of the option indicated below
(You can select more than one)

Email Phone Postal Mail
Procedure: You must select one to continue.
  *
Questions /
Comments: