Contact Us

About

If you are a hospital and would like more information from Surescripts about electronic prescribing and its related services, please complete and submit the form below:

First Name:  
 
Last Name:  
 
Title:  
 
Company:  
 
Telephone:  
 
Fax:  
 
Email:  
 
Re-Enter Email:  
 
Address:  
 
City:  
 
State:  
 
Zip Code:  
 
Inquiry:  
 


 

If you are a software vendor and are interested in becoming Surescripts certified for our prescription history service or other Surescripts services, please contact us by clicking here.