New Account Setup (Pl fill in all the details to avoid delays in processing)

Group Name (e.g. ABC Heart Center)
Contact Details : (name/number/email)
Sites of Service : (locations : office/hospital)
Name Address Type (Office|Hospital)
Individual Accounts : (email will be sent to each individual with login details)
First Name Last Name EMail Phone Mobile access (Yes|No)
Define Workroups (e.. Billing, Scheduling) [Optional] :