Ocean22 Group - StarLite Registration

The Future of Medical Technology Innovations

What are you Most Interested in Learning More About? Choose One:
Allscripts MyWay EHR
Stimulus Incentives
Physician Product Reference
Using EHR Effectively
TO REGISTER FOR A WEBINAR: Please fill in all asterisked fields
Select The WEBINAR you wish to attend:*
November 17, 2010	December 2010 (Dates TBA)
Physician's Agenda: Welcome, Introduction and Stimulus Information Description of the Physician and Practice How long the Practice has been on MyWay Why the Practice chose Allscripts Why the Practice feels MyWay is the right product What ROI the Practice have personally experienced Physician led demo of MyWay Question and Answer Session

First Name* (Main Contact)	Last Name*	Title*	Email*

First Name (Alternate Contact)	Last Name	Title	Email

Practice Name*

Address*	City*	State*	Zip*

Practice Manager First Name	Practice Manager Last Name	Practice Manager Phone	Practice Manager Fax

Estimated EHR Purchase Timeframe:	Business Website:	Main Contact Phone:*	Main Contact Fax:*
1 - 3 Months* More than 3 Months
Amount of Providers:	Additional Practice Staff:	Twitter Page:	Facebook Page:
Full Time: Part Time:	Billing: Nursing: