Renal Healthcare HIE Support Request Form

Need help? Submit a Renal Healthcare HIE Support Request form to report and receive assistance with contracting, registration, data submission and technical issues.

How to use the Renal Healthcare HIE Support Request Form

The Renal Healthcare HIE Support Request form contains several sections that need to be completed prior to submission. To use the Support Request Form do the following:

  • Indicate your organization type.
  • Provide your contact information.
  • Tell us what your question is about. Radio button checked for a specific question in this section of the support form routes the ticket to the correct support team.
  • Remember! Do not include any personal identifiable information (PII) or protected health information (PHI) in the Support Request. You may include the EQRS Patient Identifier in conjunction with the description for reference. If needed, the responding support team will provide instructions to you for sharing this type of information.

For more information on using the Support Request form, review the guide below.