PER Support Form

Please do not include PHI in this form or any attachments. If PHI is needed, please state that in your submission. A secured link will be shared with you. If you have an issue submitting this form, email PER@AHPNetwork.com directly.

Date*

Name*

Practice Name*

Email*

Issue*

Urgency*

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PER Component

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Ticket Category

Login Issue

Data Issue

Other

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All individuals submitting an access issue that includes an error message must submit a screenshot of the error message for assistance.

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