www.modmed.com
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104.155.177.55
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URL:
https://www.modmed.com/
Submission: On December 28 via manual from US — Scanned from DE
Submission: On December 28 via manual from US — Scanned from DE
Form analysis 8 forms found in the DOM
GET https://www.modmed.com/
<form role="search" method="get" class="et-search-form" action="https://www.modmed.com/">
<input type="search" class="et-search-field" placeholder="Search …" value="" name="s" title="Search for:">
</form>POST /#gf_241
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_241" id="gform_241" class="form request-demo-form gform_legacy_markup" action="/#gf_241">
<div class="gform_body gform-body">
<ul id="gform_fields_241" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_241_9" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_9"><label class="gfield_label" for="input_241_9">First
Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_9" id="input_241_9" type="text" value="" class="medium" placeholder="First Name*" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_241_10" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_10"><label class="gfield_label" for="input_241_10">Last
Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_10" id="input_241_10" type="text" value="" class="medium" placeholder="Last Name*" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_241_5" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_5"><label class="gfield_label" for="input_241_5">E-mail<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_5" id="input_241_5" type="text" value="" class="medium" placeholder="E-mail*" aria-required="true" aria-invalid="false">
</div>
</li>
<li id="field_241_6" class="gfield gf_right_half field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_6"><label class="gfield_label" for="input_241_6">Phone</label>
<div class="ginput_container ginput_container_phone"><input name="input_6" id="input_241_6" type="text" value="" class="medium" placeholder="Phone" aria-invalid="false"></div>
</li>
<li id="field_241_7" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_7"><label class="gfield_label"
for="input_241_7">State/Province<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_7" id="input_241_7" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">State/Province*</option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
</select></div>
</li>
<li id="field_241_8" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_8"><label class="gfield_label" for="input_241_8">Medical
Specialty<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_8" id="input_241_8" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Medical Specialty*</option>
<option value="ENT">Allergy</option>
<option value="Dermatology">Dermatology</option>
<option value="Gastroenterology">Gastroenterology</option>
<option value="OBGYN">OBGYN</option>
<option value="Ophthalmology">Ophthalmology</option>
<option value="Orthopedics">Orthopedics</option>
<option value="ENT">Otolaryngology</option>
<option value="Pain Management">Pain Management</option>
<option value="Plastic Surgery">Plastic Surgery</option>
<option value="Podiatry">Podiatry</option>
<option value="Urology">Urology</option>
<option value="Other">Other</option>
</select></div>
</li>
<li id="field_241_15" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_15"><label class="gfield_label"
for="input_241_15">Company<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_15" id="input_241_15" type="text" value="" class="medium" placeholder="Practice/Company Name*" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_241_21" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_21"><label class="gfield_label" for="input_241_21">Product
of Interest<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_21" id="input_241_21" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Product of Interest*</option>
<option value="EHR">EHR</option>
<option value="PM">Practice Management</option>
<option value="RCM">Billing Services</option>
<option value="Other">Other</option>
</select></div>
</li>
<li id="field_241_38" class="gfield gf_left_half field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_38"><label class="gfield_label" for="input_241_38">Number of Providers</label>
<div class="ginput_container ginput_container_number"><input name="input_38" id="input_241_38" type="text" value="" class="medium" placeholder="Number of Providers*" aria-invalid="false"></div>
</li>
<li id="field_241_42" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_42"><label class="gfield_label" for="input_241_42">Are you
a Modernizing Medicine client?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_42" id="input_241_42" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">What is your current EHR?*</option>
<option value="Other">Other</option>
<option value="Yes">I am using Modernizing Medicine</option>
</select></div>
</li>
<li id="field_241_31" class="gfield gf_full_width gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_241_31" style="display: none;"><label class="gfield_label"
for="input_241_31">Comments<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_31" id="input_241_31" type="text" value="" class="medium" placeholder="Enter name of your EHR*" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</li>
<li id="field_241_41" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_241_41" style="display: none;">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_241_41">Additional Product of Interest</label>
<div class="ginput_container ginput_container_text"><input name="input_41" id="input_241_41" type="text" value="Other" class="medium" aria-invalid="false" disabled="disabled"> </div>
</li>
<li id="field_241_30" class="gfield gform_hidden field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_241_30">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_241_30">Lead Source</label>
<div class="ginput_container ginput_container_text"><input name="input_30" id="input_241_30" type="text" value="Web" class="medium" placeholder="Web" aria-invalid="false"> </div>
</li>
<li id="field_241_32" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_241_32">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_241_32">Google: Medium</label>
<div class="ginput_container ginput_container_text"><input name="input_32" id="input_241_32" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_241_33" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_241_33">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_241_33">Google: Source</label>
<div class="ginput_container ginput_container_text"><input name="input_33" id="input_241_33" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_241_34" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_241_34">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_241_34">Google: Content</label>
<div class="ginput_container ginput_container_text"><input name="input_34" id="input_241_34" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_241_35" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_241_35">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_241_35">Google: Campaign</label>
<div class="ginput_container ginput_container_text"><input name="input_35" id="input_241_35" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_241_39" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_241_39">
<div class="ginput_container ginput_container_text"><input name="input_39" id="input_241_39" type="hidden" class="gform_hidden" aria-invalid="false" value="https://www.modmed.com/"></div>
</li>
<li id="field_241_43" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_241_43"><label class="gfield_label" for="input_241_43">Email</label>
<div class="ginput_container"><input name="input_43" id="input_241_43" type="text" value=""></div>
<div class="gfield_description" id="gfield_description_241_43">This field is for validation purposes and should be left unchanged.</div>
</li>
</ul>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_241" class="gform_button button" value="GET IN TOUCH"
onclick="if(window["gf_submitting_241"]){return false;} window["gf_submitting_241"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_241"]){return false;} window["gf_submitting_241"]=true; jQuery("#gform_241").trigger("submit",[true]); }"> <input type="hidden"
name="gform_ajax" value="form_id=241&title=&description=&tabindex=0">
<input type="hidden" class="gform_hidden" name="is_submit_241" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="241">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_241" value="WyJbXSIsIjJmZWU5NjgxOTRjNzhmMGJmMjhkYzhjNzI5ODRjMmQxIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_241" id="gform_target_page_number_241" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_241" id="gform_source_page_number_241" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>POST /#gf_623
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_623" id="gform_623" class="form request-demo-form gform_legacy_markup" action="/#gf_623">
<div class="gform_body gform-body">
<ul id="gform_fields_623" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_623_9" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_9"><label class="gfield_label" for="input_623_9">First
Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_9" id="input_623_9" type="text" value="" class="medium" placeholder="First Name*" aria-required="true" aria-invalid="false" autocomplete="given-name"> </div>
</li>
<li id="field_623_10" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_10"><label class="gfield_label" for="input_623_10">Last
Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_10" id="input_623_10" type="text" value="" class="medium" placeholder="Last Name*" aria-required="true" aria-invalid="false" autocomplete="family-name"> </div>
</li>
<li id="field_623_5" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_5"><label class="gfield_label" for="input_623_5">E-mail<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_5" id="input_623_5" type="text" value="" class="medium" placeholder="E-mail*" aria-required="true" aria-invalid="false" autocomplete="email">
</div>
</li>
<li id="field_623_6" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_6"><label class="gfield_label" for="input_623_6">Phone<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_6" id="input_623_6" type="text" value="" class="medium" placeholder="Phone*" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_623_7" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_7"><label class="gfield_label" for="input_623_7">State<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_7" id="input_623_7" class="medium gfield_select" aria-required="true" aria-invalid="false" autocomplete="address-level1">
<option value="" selected="selected" class="gf_placeholder">State/Province*</option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
</select></div>
</li>
<li id="field_623_8" class="gfield gfield--width-full gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_8"><label class="gfield_label"
for="input_623_8">Medical Specialty<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_8" id="input_623_8" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Medical Specialty*</option>
<option value="ENT">Allergy</option>
<option value="Dermatology">Dermatology</option>
<option value="Gastroenterology">Gastroenterology</option>
<option value="OBGYN">OBGYN</option>
<option value="Ophthalmology">Ophthalmology</option>
<option value="Orthopedics">Orthopedics</option>
<option value="ENT">Otolaryngology</option>
<option value="Pain Management">Pain Management</option>
<option value="Plastic Surgery">Plastic Surgery</option>
<option value="Podiatry">Podiatry</option>
<option value="Urology">Urology</option>
<option value="Other">Other</option>
</select></div>
</li>
<li id="field_623_38" class="gfield gfield--width-full gf_left_third field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_623_38">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_623_38">Position</label>
<div class="ginput_container ginput_container_text"><input name="input_38" id="input_623_38" type="text" value="" class="medium" placeholder="Position*" aria-invalid="false" autocomplete="organization-title"> </div>
</li>
<li id="field_623_15" class="gfield gfield--width-full gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_15"><label class="gfield_label"
for="input_623_15">Company<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_15" id="input_623_15" type="text" value="" class="medium" placeholder="Practice Name*" aria-required="true" aria-invalid="false" autocomplete="organization"> </div>
</li>
<li id="field_623_37" class="gfield gfield--width-full gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_37"><label class="gfield_label"
for="input_623_37">Number of Providers<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_number"><input name="input_37" id="input_623_37" type="text" value="" class="medium" placeholder="Number of Providers*" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_623_21" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_21"><label class="gfield_label" for="input_623_21">Product
of Interest<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_21" id="input_623_21" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Product of Interest*</option>
<option value="EHR">EHR</option>
<option value="PM">Practice Management</option>
<option value="RCM">Billing Services</option>
<option value="Other">Other</option>
</select></div>
</li>
<li id="field_623_39" class="gfield gfield--width-full gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_39"><label class="gfield_label"
for="input_623_39">Current PM<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_39" id="input_623_39" type="text" value="" class="medium" placeholder="Current PM*" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_623_35" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_35"><label class="gfield_label" for="input_623_35">Are you
a Modernizing Medicine client?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_35" id="input_623_35" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Current EHR*</option>
<option value="Other">Other</option>
<option value="Yes">Modernizing Medicine</option>
</select></div>
</li>
<li id="field_623_43" class="gfield gfield--width-full gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_43"><label class="gfield_label"
for="input_623_43">How did you hear about us<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_43" id="input_623_43" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">How did you hear about us*</option>
<option value="Academy website">Academy website</option>
<option value="Article in a magazine">Article in a magazine</option>
<option value="Article on the internet">Article on the internet</option>
<option value="Email">Email</option>
<option value="Facebook">Facebook</option>
<option value="Friend or colleague">Friend or colleague</option>
<option value="Google search">Google search</option>
<option value="Internet Ad">Internet Ad</option>
<option value="LinkedIn">LinkedIn</option>
<option value="Mail I received">Mail I received</option>
<option value="Package I received">Package I received</option>
<option value="Software Advice">Software Advice</option>
<option value="Tradeshow / event">Tradeshow / event</option>
<option value="Twitter">Twitter</option>
<option value="Webinar I attended">Webinar I attended</option>
<option value="YouTube video">YouTube video</option>
<option value="Other">Other</option>
</select></div>
</li>
<li id="field_623_36" class="gfield gf_full_width gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_36" style="display: none;"><label class="gfield_label"
for="input_623_36">Comments<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_36" id="input_623_36" type="text" value="" class="medium" placeholder="Enter name of your EHR*" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</li>
<li id="field_623_44" class="gfield gfield--width-full gf_full_width gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_623_44" style="display: none;"><label
class="gfield_label" for="input_623_44">How did you hear about us: other<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_44" id="input_623_44" type="text" value="" class="medium" placeholder="Please type where you heard about ModMed*" aria-required="true" aria-invalid="false"
disabled="disabled"> </div>
</li>
<li id="field_623_25" class="gfield gf_right_half field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_623_25" style="display: none;">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_623_25">Additional Product of Interest</label>
<div class="ginput_container ginput_container_select"><select name="input_25" id="input_623_25" class="medium gfield_select" aria-invalid="false" disabled="disabled">
<option value="Other" selected="selected">Other</option>
</select></div>
</li>
<li id="field_623_30" class="gfield gform_hidden field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_623_30">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_623_30">Lead Source</label>
<div class="ginput_container ginput_container_text"><input name="input_30" id="input_623_30" type="text" value="Web" class="medium" placeholder="Web" aria-invalid="false"> </div>
</li>
<li id="field_623_31" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_623_31">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_623_31">Google: Medium</label>
<div class="ginput_container ginput_container_text"><input name="input_31" id="input_623_31" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_623_32" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_623_32">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_623_32">Google: Source</label>
<div class="ginput_container ginput_container_text"><input name="input_32" id="input_623_32" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_623_33" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_623_33">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_623_33">Google: Content</label>
<div class="ginput_container ginput_container_text"><input name="input_33" id="input_623_33" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_623_34" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_623_34">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_623_34">Google: Campaign</label>
<div class="ginput_container ginput_container_text"><input name="input_34" id="input_623_34" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_623_40" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_623_40">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_623_40">Google: gclid</label>
<div class="ginput_container ginput_container_text"><input name="input_40" id="input_623_40" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_623_41" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_623_41">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_623_41">Google: term</label>
<div class="ginput_container ginput_container_text"><input name="input_41" id="input_623_41" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_623_42" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_623_42"></li>
<li id="field_623_45" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_623_45"><label class="gfield_label" for="input_623_45">Email</label>
<div class="ginput_container"><input name="input_45" id="input_623_45" type="text" value=""></div>
<div class="gfield_description" id="gfield_description_623_45">This field is for validation purposes and should be left unchanged.</div>
</li>
</ul>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_623" class="gform_button button" value="Get In Touch"
onclick="if(window["gf_submitting_623"]){return false;} window["gf_submitting_623"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_623"]){return false;} window["gf_submitting_623"]=true; jQuery("#gform_623").trigger("submit",[true]); }"> <input type="hidden"
name="gform_ajax" value="form_id=623&title=&description=&tabindex=0">
<input type="hidden" class="gform_hidden" name="is_submit_623" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="623">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_623" value="WyJbXSIsIjJmZWU5NjgxOTRjNzhmMGJmMjhkYzhjNzI5ODRjMmQxIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_623" id="gform_target_page_number_623" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_623" id="gform_source_page_number_623" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>GET https://www.modmed.com/
<form role="search" method="get" id="searchform" class="searchform" action="https://www.modmed.com/">
<div> <label class="screen-reader-text" for="s">Search for:</label> <input type="text" value="" name="s" id="s"> <input type="submit" id="searchsubmit" value="Search"></div>
</form>POST /#gf_788
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_788" id="gform_788" class="form request-demo-form gform_legacy_markup" action="/#gf_788">
<div class="gform_body gform-body">
<ul id="gform_fields_788" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_788_9" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_788_9"><label class="gfield_label" for="input_788_9">First
Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_9" id="input_788_9" type="text" value="" class="medium" placeholder="First Name*" aria-required="true" aria-invalid="false" autocomplete="given-name"> </div>
</li>
<li id="field_788_10" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_788_10"><label class="gfield_label" for="input_788_10">Last
Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_10" id="input_788_10" type="text" value="" class="medium" placeholder="Last Name*" aria-required="true" aria-invalid="false" autocomplete="family-name"> </div>
</li>
<li id="field_788_5" class="gfield gf_full_width gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_788_5"><label class="gfield_label"
for="input_788_5">E-mail<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_5" id="input_788_5" type="text" value="" class="medium" placeholder="E-mail*" aria-required="true" aria-invalid="false" autocomplete="email">
</div>
</li>
<li id="field_788_7" class="gfield gf_full_width gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_788_7"><label class="gfield_label" for="input_788_7">State<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_7" id="input_788_7" class="medium gfield_select" aria-required="true" aria-invalid="false" autocomplete="address-level1">
<option value="" selected="selected" class="gf_placeholder">State/Province*</option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
</select></div>
</li>
<li id="field_788_6" class="gfield gfield--width-full gf_full_width field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_788_6"><label class="gfield_label" for="input_788_6">Phone</label>
<div class="ginput_container ginput_container_phone"><input name="input_6" id="input_788_6" type="text" value="" class="medium" placeholder="Phone" aria-invalid="false"></div>
</li>
<li id="field_788_8" class="gfield gfield--width-full gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_788_8">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_8">Medical Specialty<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_8" id="input_788_8" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" class="gf_placeholder">Medical Specialty*</option>
<option value="Dermatology">Dermatology</option>
<option value="Gastroenterology">Gastroenterology</option>
<option value="OBGYN" selected="selected">OBGYN</option>
<option value="Ophthalmology">Ophthalmology</option>
<option value="Orthopedics">Orthopedics</option>
<option value="ENT">Otolaryngology</option>
<option value="Pain Management">Pain Management</option>
<option value="Plastic Surgery">Plastic Surgery</option>
<option value="Podiatry">Podiatry</option>
<option value="Urology">Urology</option>
<option value="Other">Other</option>
</select></div>
</li>
<li id="field_788_38" class="gfield gfield--width-full gf_left_third field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_788_38">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_38">Position</label>
<div class="ginput_container ginput_container_text"><input name="input_38" id="input_788_38" type="text" value="" class="medium" placeholder="Position*" aria-invalid="false" autocomplete="organization-title"> </div>
</li>
<li id="field_788_15" class="gfield gfield--width-full gf_full_width gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_788_15"><label class="gfield_label"
for="input_788_15">Company<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_15" id="input_788_15" type="text" value="" class="medium" placeholder="Practice Name*" aria-required="true" aria-invalid="false" autocomplete="organization"> </div>
</li>
<li id="field_788_37" class="gfield gfield--width-full gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_788_37">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_37">Number of Providers<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_number"><input name="input_37" id="input_788_37" type="text" value="1" class="medium" placeholder="Number of Providers*" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_788_21" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_788_21">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_21">Product of Interest<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_21" id="input_788_21" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" class="gf_placeholder">Product of Interest*</option>
<option value="EHR" selected="selected">EHR</option>
<option value="PM">Practice Management</option>
<option value="RCM">Billing Services</option>
<option value="Other">Other</option>
</select></div>
</li>
<li id="field_788_39" class="gfield gfield--width-full gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_788_39">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_39">Current PM<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_39" id="input_788_39" type="text" value="Other" class="medium" placeholder="Current PM*" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_788_35" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_788_35">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_35">Are you a Modernizing Medicine client?<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_35" id="input_788_35" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" class="gf_placeholder">Current EHR*</option>
<option value="Other" selected="selected">Other</option>
<option value="Yes">Modernizing Medicine</option>
</select></div>
</li>
<li id="field_788_36" class="gfield gf_full_width gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_788_36">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_36">Comments<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_36" id="input_788_36" type="text" value="Other" class="medium" placeholder="Enter name of your EHR*" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_788_25" class="gfield gf_right_half field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_788_25" style="display: none;">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_25">Additional Product of Interest</label>
<div class="ginput_container ginput_container_select"><select name="input_25" id="input_788_25" class="medium gfield_select" aria-invalid="false" disabled="disabled">
<option value="Other" selected="selected">Other</option>
</select></div>
</li>
<li id="field_788_30" class="gfield gform_hidden field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_788_30">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_30">Lead Source</label>
<div class="ginput_container ginput_container_text"><input name="input_30" id="input_788_30" type="text" value="Web" class="medium" placeholder="Web" aria-invalid="false"> </div>
</li>
<li id="field_788_31" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_788_31">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_31">Google: Medium</label>
<div class="ginput_container ginput_container_text"><input name="input_31" id="input_788_31" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_788_32" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_788_32">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_32">Google: Source</label>
<div class="ginput_container ginput_container_text"><input name="input_32" id="input_788_32" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_788_33" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_788_33">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_33">Google: Content</label>
<div class="ginput_container ginput_container_text"><input name="input_33" id="input_788_33" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_788_34" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_788_34">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_34">Google: Campaign</label>
<div class="ginput_container ginput_container_text"><input name="input_34" id="input_788_34" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_788_40" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_788_40">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_40">Google: gclid</label>
<div class="ginput_container ginput_container_text"><input name="input_40" id="input_788_40" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_788_41" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_788_41">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_788_41">Google: term</label>
<div class="ginput_container ginput_container_text"><input name="input_41" id="input_788_41" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_788_42" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_788_42"></li>
<li id="field_788_43" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_788_43"><label class="gfield_label" for="input_788_43">Phone</label>
<div class="ginput_container"><input name="input_43" id="input_788_43" type="text" value=""></div>
<div class="gfield_description" id="gfield_description_788_43">This field is for validation purposes and should be left unchanged.</div>
</li>
</ul>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_788" class="gform_button button" value="SUBMIT" onclick="if(window["gf_submitting_788"]){return false;} window["gf_submitting_788"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_788"]){return false;} window["gf_submitting_788"]=true; jQuery("#gform_788").trigger("submit",[true]); }"> <input type="hidden"
name="gform_ajax" value="form_id=788&title=&description=&tabindex=0">
<input type="hidden" class="gform_hidden" name="is_submit_788" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="788">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_788" value="WyJbXSIsIjJmZWU5NjgxOTRjNzhmMGJmMjhkYzhjNzI5ODRjMmQxIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_788" id="gform_target_page_number_788" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_788" id="gform_source_page_number_788" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>POST /#gf_656
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_656" id="gform_656" class="form request-demo-form gform_legacy_markup" action="/#gf_656">
<div class="gform_body gform-body">
<ul id="gform_fields_656" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_656_9" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_9"><label class="gfield_label" for="input_656_9">First
Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_9" id="input_656_9" type="text" value="" class="medium" placeholder="First Name*" aria-required="true" aria-invalid="false" autocomplete="given-name"> </div>
</li>
<li id="field_656_10" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_10"><label class="gfield_label" for="input_656_10">Last
Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_10" id="input_656_10" type="text" value="" class="medium" placeholder="Last Name*" aria-required="true" aria-invalid="false" autocomplete="family-name"> </div>
</li>
<li id="field_656_5" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_5"><label class="gfield_label" for="input_656_5">E-mail<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_5" id="input_656_5" type="text" value="" class="medium" placeholder="E-mail*" aria-required="true" aria-invalid="false" autocomplete="email">
</div>
</li>
<li id="field_656_6" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_6"><label class="gfield_label" for="input_656_6">Phone<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_6" id="input_656_6" type="text" value="" class="medium" placeholder="Phone*" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_656_7" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_7"><label class="gfield_label" for="input_656_7">State<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_7" id="input_656_7" class="medium gfield_select" aria-required="true" aria-invalid="false" autocomplete="address-level1">
<option value="" selected="selected" class="gf_placeholder">State/Province*</option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="DC">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
</select></div>
</li>
<li id="field_656_8" class="gfield gfield--width-full gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_8"><label class="gfield_label"
for="input_656_8">Medical Specialty<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_8" id="input_656_8" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Medical Specialty*</option>
<option value="ENT">Allergy</option>
<option value="Dermatology">Dermatology</option>
<option value="Gastroenterology">Gastroenterology</option>
<option value="OBGYN">OBGYN</option>
<option value="Ophthalmology">Ophthalmology</option>
<option value="Orthopedics">Orthopedics</option>
<option value="ENT">Otolaryngology</option>
<option value="Pain Management">Pain Management</option>
<option value="Plastic Surgery">Plastic Surgery</option>
<option value="Podiatry">Podiatry</option>
<option value="Urology">Urology</option>
<option value="Other">Other</option>
</select></div>
</li>
<li id="field_656_38" class="gfield gfield--width-full gf_left_third field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_656_38">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_656_38">Position</label>
<div class="ginput_container ginput_container_text"><input name="input_38" id="input_656_38" type="text" value="" class="medium" placeholder="Position*" aria-invalid="false" autocomplete="organization-title"> </div>
</li>
<li id="field_656_15" class="gfield gfield--width-full gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_15"><label class="gfield_label"
for="input_656_15">Company<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_15" id="input_656_15" type="text" value="" class="medium" placeholder="Practice Name*" aria-required="true" aria-invalid="false" autocomplete="organization"> </div>
</li>
<li id="field_656_37" class="gfield gfield--width-full gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_37"><label class="gfield_label"
for="input_656_37">Number of Providers<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_number"><input name="input_37" id="input_656_37" type="text" value="" class="medium" placeholder="Number of Providers*" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_656_21" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_21"><label class="gfield_label" for="input_656_21">Product
of Interest<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_21" id="input_656_21" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Product of Interest*</option>
<option value="EHR">EHR</option>
<option value="PM">Practice Management</option>
<option value="RCM">Billing Services</option>
<option value="Other">Other</option>
</select></div>
</li>
<li id="field_656_39" class="gfield gfield--width-full gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_39"><label class="gfield_label"
for="input_656_39">Current PM<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_39" id="input_656_39" type="text" value="" class="medium" placeholder="Current PM*" aria-required="true" aria-invalid="false"> </div>
</li>
<li id="field_656_35" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_35"><label class="gfield_label" for="input_656_35">Are you
a Modernizing Medicine client?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_35" id="input_656_35" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">Current EHR*</option>
<option value="Other">Other</option>
<option value="Yes">Modernizing Medicine</option>
</select></div>
</li>
<li id="field_656_43" class="gfield gfield--width-full gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_43"><label class="gfield_label"
for="input_656_43">How did you hear about us<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_43" id="input_656_43" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="" selected="selected" class="gf_placeholder">How did you hear about us*</option>
<option value="Academy website">Academy website</option>
<option value="Article in a magazine">Article in a magazine</option>
<option value="Article on the internet">Article on the internet</option>
<option value="Email">Email</option>
<option value="Facebook">Facebook</option>
<option value="Friend or colleague">Friend or colleague</option>
<option value="Google search">Google search</option>
<option value="Internet Ad">Internet Ad</option>
<option value="LinkedIn">LinkedIn</option>
<option value="Mail I received">Mail I received</option>
<option value="Package I received">Package I received</option>
<option value="Software Advice">Software Advice</option>
<option value="Tradeshow / event">Tradeshow / event</option>
<option value="Twitter">Twitter</option>
<option value="Webinar I attended">Webinar I attended</option>
<option value="YouTube video">YouTube video</option>
<option value="Other">Other</option>
</select></div>
</li>
<li id="field_656_36" class="gfield gf_full_width gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_36" style="display: none;"><label class="gfield_label"
for="input_656_36">Comments<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_36" id="input_656_36" type="text" value="" class="medium" placeholder="Enter name of your EHR*" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</li>
<li id="field_656_44" class="gfield gfield--width-full gf_full_width gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_656_44" style="display: none;"><label
class="gfield_label" for="input_656_44">How did you hear about us: other<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_44" id="input_656_44" type="text" value="" class="medium" placeholder="Please type where you heard about ModMed*" aria-required="true" aria-invalid="false"
disabled="disabled"> </div>
</li>
<li id="field_656_25" class="gfield gf_right_half field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_656_25" style="display: none;">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_656_25">Additional Product of Interest</label>
<div class="ginput_container ginput_container_select"><select name="input_25" id="input_656_25" class="medium gfield_select" aria-invalid="false" disabled="disabled">
<option value="Other" selected="selected">Other</option>
</select></div>
</li>
<li id="field_656_30" class="gfield gform_hidden field_sublabel_below field_description_below hidden_label gfield_visibility_hidden" data-js-reload="field_656_30">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_656_30">Lead Source</label>
<div class="ginput_container ginput_container_text"><input name="input_30" id="input_656_30" type="text" value="Web" class="medium" placeholder="Web" aria-invalid="false"> </div>
</li>
<li id="field_656_31" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_656_31">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_656_31">Google: Medium</label>
<div class="ginput_container ginput_container_text"><input name="input_31" id="input_656_31" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_656_32" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_656_32">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_656_32">Google: Source</label>
<div class="ginput_container ginput_container_text"><input name="input_32" id="input_656_32" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_656_33" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_656_33">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_656_33">Google: Content</label>
<div class="ginput_container ginput_container_text"><input name="input_33" id="input_656_33" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_656_34" class="gfield field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_656_34">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_656_34">Google: Campaign</label>
<div class="ginput_container ginput_container_text"><input name="input_34" id="input_656_34" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_656_40" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_656_40">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_656_40">Google: gclid</label>
<div class="ginput_container ginput_container_text"><input name="input_40" id="input_656_40" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_656_41" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_hidden" data-js-reload="field_656_41">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label" for="input_656_41">Google: term</label>
<div class="ginput_container ginput_container_text"><input name="input_41" id="input_656_41" type="text" value="" class="medium" aria-invalid="false"> </div>
</li>
<li id="field_656_42" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_656_42"></li>
<li id="field_656_45" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_656_45"><label class="gfield_label" for="input_656_45">Name</label>
<div class="ginput_container"><input name="input_45" id="input_656_45" type="text" value=""></div>
<div class="gfield_description" id="gfield_description_656_45">This field is for validation purposes and should be left unchanged.</div>
</li>
</ul>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_656" class="gform_button button" value="Get In Touch"
onclick="if(window["gf_submitting_656"]){return false;} window["gf_submitting_656"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_656"]){return false;} window["gf_submitting_656"]=true; jQuery("#gform_656").trigger("submit",[true]); }"> <input type="hidden"
name="gform_ajax" value="form_id=656&title=&description=&tabindex=0">
<input type="hidden" class="gform_hidden" name="is_submit_656" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="656">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_656" value="WyJbXSIsIjJmZWU5NjgxOTRjNzhmMGJmMjhkYzhjNzI5ODRjMmQxIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_656" id="gform_target_page_number_656" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_656" id="gform_source_page_number_656" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>POST /#gf_501
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_501" id="gform_501" class="form request-demo-form gform_legacy_markup" action="/#gf_501">
<div class="gform_body gform-body">
<ul id="gform_fields_501" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_501_9" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_501_9"><label class="gfield_label" for="input_501_9">First
Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_9" id="input_501_9" type="text" value="" class="medium" placeholder="First Name*" aria-required="true" aria-invalid="false" autocomplete="given-name"> </div>
</li>
<li id="field_501_10" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_501_10"><label class="gfield_label" for="input_501_10">Last
Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_10" id="input_501_10" type="text" value="" class="medium" placeholder="Last Name*" aria-required="true" aria-invalid="false" autocomplete="family-name"> </div>
</li>
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* Specialty Solutions
* * AllergyNew!
* * SOLUTIONS
* * EHR
* Practice Management
* Patient Engagement
* * Telehealth
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* MORE TO EXPLORE
* * ModMed® Pay
* Client Services
* ePrescribing
* Faxing
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* Let’s talk!
* *
* Close
* Dermatology
* * SOLUTIONS
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* * Inventory Management
* Pathology
* Revenue Cycle Management
* MORE TO EXPLORE
* * Analytics
* ModMed® Pay
* Telehealth
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* Interoperability
* * Client Services
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* Success Stories
* Videos
* Let’s talk!
* *
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* Gastroenterology
* * SOLUTIONS
* * gGastro® EHR
* gGastro ERW
* gGastro ASC
* * gPM™
* Revenue Cycle Management
* gInsights™
* ADDT'L SERVICES & PATIENT ENGAGEMENT
* * Marketing Services
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* * gKiosk™
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* gEstimator™
* *
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* OBGYNNew!
* * SOLUTIONS
* * EHR
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* MORE TO EXPLORE
* * Value-Based Care
* Population Health
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* *
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* Ophthalmology
* * SOLUTIONS
* * EHR
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* * ASC
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* MORE TO EXPLORE
* * Optical Inventory
* Patient Engagement
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* * SOLUTIONS
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U.S. GRANTS MODMED AN EHR PATENT
Read More!
WHAT DO PATIENTS REALLY THINK?
It’s about time to find out. Download report.
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ARE PATIENTS FINDING YOUR PRACTICE?
Expand your online presence with ModMed AMP
IT’S ABOUT TIME
to rethink your staffing strategy
#1 INTEGRATED SOLUTION IN 2022
Practice Management, RCM and EHR that work seamlessly across your practice.
IT’S ABOUT TIME
your software felt like it was designed just for you.
PreviousNext
SPECIALTY-SPECIFIC EHR SYSTEMS AND SOLUTIONS
CHOOSE YOUR SPECIALTY BELOW TO LEARN MORE
ALLERGY
DERMATOLOGY
GASTROENTEROLOGY
OBGYN
OPHTHALMOLOGY
ORTHOPEDICS
OTOLARYNGOLOGY
PainMed
PAIN MANAGEMENT
PLASTIC SURGERY
PODIATRY
UROLOGY
INTUITIVE HEALTHCARE SOFTWARE SOLUTIONS
We believe quality healthcare is more achievable when your focus is on the
patient, not clunky software. That’s why Modernizing Medicine® created intuitive
solutions to free EMA® and gGastro® EHR users from the burden of excessive
typing and clicking. Now you can treat your patient while allowing our
technology to document the entire experience. EMA is even available on your
iPad.
Instead of adding more work to your day, Modernizing Medicine brings the human
experience back into the exam room, just as the best healthcare technology
should.
EHRModMed BOOSTERWANALYTICSSERVICESRESOURCES
derm-vid-pop
derm-ehr
gastro-ehr
opht-ehr
ortho-ehr
oto-ehr
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derm-ehr
gastro-ehr
opht-ehr
ortho-ehr
oto-ehr
PreviousNext
TIME IS ON OUR SIDE, IS IT ON YOURS?
000
00
Day(s)
:
00
Hour(s)
:
00
Minute(s)
:
00
Second(s)
Our demo will show you how you could save valuable time with each patient.
Every. Single. Day.
Show me how
WORK. LIFE. BALANCED.
What happens when you select a specialty-specific electronic health records
(EHR) system built and maintained by practicing physicians? Tedious processes
that used to slow you down suddenly become automated. Subtle nuances that
separate subspecialty workflow are accounted for. And your newfound mobility
with our EHRs conveniently places your office in the palm of your hand wherever
you go. So what happens when you select systems like EMA and gGastro EHR? Turns
out, it depends on what you choose to do with the extra time you now have.
What’s hanging in the balance for you?
SELECT YOUR SPECIALTY TO LEARN MORE
* Allergy
* Dermatology
* Gastroenterology
* OBGYN
* Ophthalmology
* Orthopedics
* Otolaryngology
* Pain Management
* Plastic Surgery
* Urology
SELECT YOUR SPECIALTY TO LEARN MORE
* Allergy
* Dermatology
* Gastroenterology
* OBGYN
* Ophthalmology
* Orthopedics
* Otolaryngology
* Pain Management
* Plastic Surgery
* Urology
WE ARE MODERNIZING MEDICINE®
PREPARING YOU FOR WHAT’S NEXT
Exceedingly effective healthcare technology—that’s what we achieved by breaking
away from the crowd to create our award-winning EHR systems, EMA and gGastro
EHR. Since then, we’ve continued to learn from our clients about what would make
our software even better. The result? Specialty-specific suites of products and
services that seamlessly integrate with our powerful electronic health records
software.
ELECTRONIC HEALTH RECORDS SYSTEM
You wouldn’t go to a dermatologist for an eye exam. So why use the same
technology? EMA and gGastro EHR have specific knowledge of your workflow. EMA is
even capable of learning and then adjusting to how you practice. But don’t just
take our word for it. See what makes EMA or gGastro the right EHR system for
your practice in the new age of value-based care.
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MODMED® BOOST | MODMED GBOOST
When you decided to become a physician, it probably wasn’t because of the
billing and administrative work. If business-related issues are bogging you
down, ModMed® BOOST can help free you up to focus on patients while also helping
you achieve better efficiency.
Includes:
PRACTICE MANAGEMENT
Simplify your workday with our all-in-one technology designed to bridge the gap
between the front and back offices. Our innovative practice management (PM)
systems are fully integrated with our EHRs, helping you schedule appointments,
access metrics-driven reporting, and manage documents and billing.
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BUSINESS OPERATIONS SERVICES
Join hundreds of clients who are saving time and gaining peace of mind with help
from our dedicated billing specialists. We can work with you to help fix issues,
increase financial visibility and speed up your revenue cycle.
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GGASTRO ENDOSCOPY REPORT WRITER
When you combine the leading GI EHR system with an innovative Endoscopy Report
Writer like our gGastro ERW, you can benefit from an all-in-one system designed
to help optimize your ASC or hospital. Our integrated EHR and endowriter offer
built-in GI knowledge, full-text record search capabilities, customized workflow
and so much more.
Learn more
ADVISORY SERVICES
It’s not just our products that make Modernizing Medicine the go-to choice for
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your practice with access to professionals who can help you succeed in the age
of value over volume.
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ANALYTICS
To help optimize your performance under value-based care, it’s not enough to
just track the few basic metrics you get with other reporting platforms. That’s
why Modernizing Medicine’s analytics solutions bring together your clinical,
financial and operational data, providing interactive reports on the health of
your practice. You can drill down from practice to patient level, filter by what
matters to you and compare outcomes with peers. By understanding the full
picture, you’re better equipped to deliver high-quality, cost-effective care and
work towards succeeding under MIPS.
* Manage population health; find patients lost to follow-up for high-risk
diagnoses
* Spot trends in reimbursements before they affect cash flow
* Track outbound referrals to identify specialized services worth bringing in
house
* Analyze the clinical and financial impact of your treatment decisions over
time
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WELL, THAT WAS FAST
Designed with three things in mind—speed, convenience and adaptability—our
innovative EHR architecture is built for doctors who want to move swiftly and
easily through their day. Whether you’re in the office or on the go, we have
options for you that contain specialty-specific workflow and can even generate
notes and automatically suggest codes and bills as you finish the exam. It’s
that quick!
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MORE TO EXPLORE
VALUE-BASED CARE
Unlike other EHR software solutions, our 2015 Edition Certified EHR products
have been designed to embrace the arrival of value-based care. As other
practices struggle to integrate add-on MIPS solutions into their workflows, you
can take advantage of EMA and gGastro EHR’s built-in MIPS solution:
* Collect your MIPS data within the flow of the exam
* Track your estimated MIPS composite score on a daily basis
* View your estimated progress on each measure
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POPULATION HEALTH
As population health continues to gain momentum in healthcare, you’ll need
strong data analytics tools to stay competitive under MIPS and MACRA. Population
health is driven by health-system-generated data; the ability to enhance this
using patient-generated data is just one more way our EHRs stand out from the
crowd. By utilizing our solutions to gain insight into quality measures, care
utilization and population trends, you can help your practice meet CMS
requirements to attain a better position on the performance curve.
Make Data-Driven Decisions to Improve Health
PATIENT ENGAGEMENT
From an innovative patient kiosk app to automated appointment reminders, patient
satisfaction surveys and a robust patient portal, Modernizing Medicine’s
cutting-edge technology helps you get patients more involved in their own care.
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* Plastic Surgery
* Urology
INTEROPERABILITY
We believe strongly in improving healthcare by allowing patient data to flow
seamlessly between systems. For doctors, interoperability could mean time
savings, a reduction in errors and improved insight. At Modernizing Medicine,
we’re proud to provide powerful data exchange and software interface
capabilities.
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SERVICES & SUPPORT
Our support doesn’t end after implementation. Once you join the Modernizing
Medicine family, we’ll work hard to keep you running smoothly!
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NEXT STEPS? SEE OUR TECHNOLOGY FOR YOURSELF.
Request a demo today
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Cost and Limitations and Other Disclosures for Modernizing Medicine, Inc.’s 2015
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Edition Cures Act Update
Costs and Limitations and Other Disclosures for Modernizing Medicine
Gastroenterology, Inc.’s (formerly gMed, Inc.) 2015 Edition Certified Products
Costs and Limitations and Other Disclosures for Modernizing Medicine
Gastroenterology, Inc.’s (formerly gMed, Inc.) 2015 Edition Cures Act Update
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