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First Name
Email
Organization
Role / Title
How many staff work in your office?
What’s your biggest operational challenge right now?
How many hours per week does your staff spend on repetitive administrative tasks (e.g., claim calls, appointment booking, prescription follow-ups)?
Would you be open to a short discovery call or beta access?
Would you be open to a short discovery call or beta access?
Yes
No
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Which features are most important to you?
Claim status automation
Prescription status updates
Refill reminders
Appointment scheduling
Referral tracking
Other (please specify)
Other (please specify)
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