Select the area of EQRS * -- Please select an option below -- Add/Edit Facility Personnel Default Preferences Attestation 2744 Form Other Admit Patients Search Patients 2728 Form 2746 Form Discharge Patient Transients Add/Edit Treatment Patient Attributes Other Add Personnel Edit Personnel Delete Personnel Other Reports Search Patient Add Clinical Edit Clinical Other Filter Accretions Action Selections Resolve Accretions Other Add/Edit Role Add/Edit Scope Other New User Training Online & WebEx Training CRAFT & EQRS Newsletters EQRS Login System Issues CMS Policy Other
Briefly describe the issue requiring support *Please do not enter patient names, dates of birth, social security numbers, or any other information that could potentially identify an individual. Submitting this information is a violation of CMS Data Policies.
Please provide the 10-digit CROWN UPI number for the patient *
Please provide any other comments that may help the support team resolve this issue
Your Name *
6-digit facility CCN or Organization Number *
Your Email *
Your Phone * - - EXT.
Would you like a confirmation email? I would like a confirmation email
When finished, click Submit I attest that I have not entered any PHI in the fields I am about to submit
What task are you trying to perform that you need help with? *Please do not enter patient names, dates of birth, social security numbers, or any other information that could potentially identify an individual. Submitting this information is a violation of CMS Data Policies.
Have you performed this task before but it’s just not working right now, or is this a new task you need to learn? * Need to learn Need to re-learn Done this before, but not working
6-digit facility CCN (if available)
Thank you for your interest in helping to make EQRS better!Please describe your idea in the box to the right. Be as descriptive as possible. *Please do not enter patient names, dates of birth, social security numbers, or any other information that could potentially identify an individual. Submitting this information is a violation of CMS Data Policies.
Please tell us how we can contact you if we have questions:
What can we help you with today? *Please be as descriptive as possible.Please do not enter patient names, dates of birth, social security numbers, or any other information that could potentially identify an individual. Submitting this information is a violation of CMS Data Policies.