Electronic Form: Facility Room Details

Please use your written worksheet to complete this form for each of the rooms in your facility where emrXL is expected to be used with patients (examination rooms, treatment rooms, psychosocial support, pharmacy, reception, etc)  

Your Details

Your Name (person completing this form)(Required)

Rooms and Offices (primary emrXL usage rooms)

Enter details for each room in your facility where emrXL is primarily used. This is generally going to be rooms where patients are present, such as examination rooms, treatment rooms, reception, pharmacy, social work, subspecialties, etc.
Rooms List(Required)
Click the + symbol each time to add additional rooms.
Room Name
Room ID (optional)
Phone Number or Extension
 

Organization & Site Details

Launch Guidelines, Worksheets, and other Tools

emrXL Upgrade Guidelines

Worksheet:
Launch Team Members

Online Form:
Launch Team Members

Worksheet:
Drug Categorization

Online Form:
Drug Categorization

Worksheet:
Room Details

Online Form:
Room Details

Worksheet:
I.T. Infrastructure