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System Requirements for Easy Dental SoftwareSystem
Requirements

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First Name
Initial
Last Name
Practice Name
Address
City
 State
 Zip
Phone
Email
Fax
Serial Number(s)
       
My Operating System:  
  Windows 98
Windows NT 4.0/2000
 Windows XP
Windows 2003 		 
My Easy Dental system is owned by:  
  An individual doctor
 More than one doctor  
My preferred method of contact:  
  Mail
Fax
Phone
Email 		 
Please send news, product information, and other Easy Dental messages to my email inbox
  Yes No    
Are you interested in obtaining training for Easy Dental products?
  Yes No    
Are you interested in obtaining information on electronic services that are integrated with Easy Dental such as electronic claims and electronic automated billing?  
  Yes No    
Are you interested in obtaining information on third-party Internet services, such as free web page hosting, free electronic mail, and other premium services?  
  Yes No  
What is your specialty (GP, ortho, etc)?
   
Who is your primary dental supplier?
  Sullivan Schein
Patterson
Benco
Other 		 
Mothers Maiden Name
 
 
       

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Henry Schein Practice Solution. Total solution provider.


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