Please select the department you're trying to contact.
Did your site recently go live?
Please select your business and practice. AEG option is ONLY for DSC and RCM members.
Please define if this is a request for hardware if applicable or a typical IT request.
Select EEHR Issue type
Full Patient First and Last Name
Format is "Month XX, YYYY" where month is the month's full name typed out, the XX is the two digit number, and the YYYY is the 4 digit year. The comma IS required. Otherwise, please click on the calendar.
Check if this is a request to add lenses to ALE.
Check this box for requests to add new products into ALE.
(Please enter in format Eye-Bridge-Temple)
Please select all equipment needed for this new hire request (If none, please select none)
Please select all fields requested. Please note that some of these will have to be handled by other teams.
If Egnyte was selected, please let us know what folders they need access to.
Please let us know what domain the users email will need to be created under if not @aeg
This is to help with shipping and sending techs
Please enter the details of your request. A member of our support staff will respond as soon as possible.
This is not the correct place to submit a ticket. Please check the box to confirm that you understand you're submitting a ticket in the improper queue. Please refer to the IT Support queue for most IT needs. Thank you.