Data Migration Request Form
Data migration refers to the AR team migrating patient records, or future appointments.
Business Name
*
Who is the best point-of-contact for organizing your onboarding or training plan?
*
Email
*
Which AR Team Member is assisting you?
*
Don Denham
Ellysa Boria
Harris Harr
Jennifer Hancock
Kristin Ortiz
Marc Rodriguez
Nathan Solis
Raymond De Los Santos
Not Listed
Would you like AR to migrate your patient records?
*
Yes
No
Approximately how many patient documents do you need migrated?
Which system houses your patient records?
*
Aesthetics Pro
DaySmart
Dr. Chrono
Jane
Kareo(Tebra)
Practice Fusion
Rx Photo
Vagaro
Other
Please enter the login URL for the system that houses your patient records
*
Would you like your future appointments migrated?
*
Yes
No
Please enter the login URL for the system that houses your future appointments
*
Approximately how many appointments will you need us to migrate?
*
Submit