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If you would like to request a personal demo, please fill out the information below.
Contact Information
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M.D.
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Practice Information
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Allergy
Cardiology
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Number of Providers
1-2   
3-5    
6-10    
11+   
Billing Outsourced
Yes   
No   
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Current EMR used
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How did you hear about GeniusDoc?
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Purchase Timeframe
    Immediate
    1-3 Months
    3-6 months
    6-12 months
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