Arkansas WebIZ Help Desk
Arkansas WebIZ Help Desk
Arkansas WebIZ Help Desk
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Combine 2 or more patient records
Submit a Support Request
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Name:
Email:
Confirm Email:
Job Title:
Facility name:
Facility Phone Number:
What is the best number to reach you at?
store# / clinic# (ex: Walmart #1):
WebIZ Username:
Patient ID #1 to be combined:
Patient ID #2 to be combined:
Patient ID #3 to be Combined:
Patient ID #4 to be combined:
Correct Spelling/DOB for patient:
Subject:
Message:
Suggested knowledgebase articles:
Please check to make sure each of these are true:
I am only submitting for one patient
This patient is NOT a twin
All requested information is included
I have indicated the correct spelling of First & Last name in addition to DOB
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All necessary information has been filled out.
All information is correct and error-free.
We have:
18.118.19.123 recorded as your IP Address
recorded the time of your submission
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