Heidi Multi Provider Form - Accuro EMR

Accuro AI Scribe - Powered by Heidi, multi-provider form.

Please fill all required fields below.

Are you currently using Heidi?(Required)

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Secondary Lead Source - No(Required)

Not a Heidi User

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Product of Interest(Required)

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Lead Source(Required)

Title/Role(Required)

First Name(Required)

Last Name(Required)

Email(Required)

Clinic Name(Required)

Clinic Phone(Required)

Additional Providers

Note: These are the Providers that you want individually set up. Do not simply say “all” as each name, email, Accuro office name and if they are currently using Heidi is necessary.

Additional Providers List(Required)

Title/Role *

First Name *

Last Name *

Email *

Current Heidi User? (Y/N) *

List the office(s) you want setup *

Add/Remove rows based on Providers (Max. 20). If you have more than 20, please email us at marketing@qhrtech.com

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