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Please Note: PHI or other sensitive information that makes individual health or billing information identifiable should only be entered into this system if absolutely necessary.
Requestor Information
Phone Number
Room Number
Incident Details
Subject
A short description to explain the nature of a ticket.
Description
The full details of a ticket, including any appropriate circumstances or supplementary information that may aid in resolving it.
Press Alt + 0 within the editor to access accessibility instructions, or press Alt + F10 to access the menu.
Content
Attachment
File attachments associated with the ticket.
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Other Fields
Your name
Your first name
Your last name
Your email address
Verification Code