Help Desk - Grateful Patient Data Inquiry

Name

Do you need a GP Physician List

Yes

Physician Name

Range of Service Dates

Visit Type

Inpatient

Outpatient

BlackBaud Wealth Ratings

GP folder to which the request should be added

By when would you like to receive the information you are requesting?

Please provide a detailed description of what data you would like to receive.

Please upload any files, documents, and images (including signatures) to assist us in the completion of this project. Please do not upload any files containing Protected Health Information!

Drop files here or

Max. file size: 98 MB.

Additional Notes

Request status

Help Desk – Grateful Patient Data Inquiry