Cortex User Group

CORTEX Medical Management Systems

Support Request

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Date:      

Customer Name:

Submitter Name:  

Submitter’s Phone Number:

Submitter’s Fax Number:  

Cortex Version:

Menu/Screen/Report Name:

Urgency:     1-most urgent 2 3 4 5-least urgent

Request Details:

          

Will you be forwarding any necessary print screens or documentation?  Yes    No (be certain to reference this request when you email/fax/post your attachments)

Click on submit to email to CUG President