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Send us your request for information by using the form below.
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Phone: (888) 965-4248    Fax: (410) 998-1045    E-mail: sales@hcit-emr.com

Your Name *

Your Title *

Practice/Dept Name *

Practice Specialty *

Street Address 1 *

Street Address 2 *

City *

State or Province *

Zip/Postal Code *

Phone Number *   Ext.

Fax Number

E-Mail *

Which products are you interested in? (please check all that apply)
NoPaperFiles.com - Business Edition
Practice Management (Billing, Scheduling, Collections)


NoPaperFiles.com - Medical Edition
ASC Ambulatory Surgery Center EMR
Retina+ EMR
Multi-Specialty EyeMD EMR

Number of doctors in your group: MDs, ODs

What are you requesting at this time? (please check all that apply)
A phone call
Promotional Materials
Product Demonstration


What is your timeframe for a new system?

How did you learn about HCIT?


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