EPR Task List

Use this form to: Report a bug with PatientSource Request new features or changes Request a change to an EPR form or for a new form be created Request a report from info held within PatientSource

Requested by (full name):*

E-Mail*

Job Title, Ward, Department*

Date Requested.*

Request/Report Type*

Select

Bug Reporting

Include: What happened: What should happen: Steps to reproduce the bug: Screenshots taken can be added at the bottom of this form.

Feature Request/Change

Include: As a... DOCTOR / NURSE / THERAPIST / ADMINISTRATOR / IT / ETC I want to... (describe feature request/change) So that I... (give reason for request/change)

Report Request

Include: As a... DOCTOR / NURSE / THERAPIST / ADMINISTRATOR/ ETC I want to... ( include, details of the report and where this information can be found within PatientSource (eg. drugs chart, form name, etc.) So that I... (need /rational for the report)

New Form or Form Change Request

Include: As a... DOCTOR / NURSE / THERAPIST / ADMINISTRATOR / IT / ETC I want to... (describe form change/need) So that I... (give reason for the change/new form) Attach supporting documents/forms below.

Request/Issue Summary*

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