OSPHL Electronic Order and Result Interface Interest

Organization Name

What is the name of the Electronic Health Record or Laboratory Information Management System you want to interface with OSPHL's system(s)?

Select from the list or type in your own.

Select or enter value

Which of OSPHL's testing areas would you like to interface with?

Communicable Disease

Newborn Screening

Programmatic/Operational Contact Name

Programmatic/Operational Contact Email

Programmatic/Operational Contact Phone

Phone

Data Exchange Contact Name

Data Exchange Contact Email

Data Exchange Contact Phone

Phone

Are you planning any future data system changes in your organization in the next few years? If yes, please describe.

Please enter any additional information you think we may need about your request.

Send me a copy of my responses