- IHSEDR

1. Dentrix Enterprise Version:

i

1a. Global Add-ons:

Electronic Claims

Appointment Reminder System

1b. IHS Features:

Electronic Patient Health History Form

Oral Health Status Measure

Clinical Note Dashboard

Dynamic Reporting Interface

2. Electronic Dental Record system if other than Dentrix Enterprise (n/a is a valid response):

3. Does your site have a SMTP e-mail relay server or access to one that it can use to relay Ensemble e-mail alerts to the IHS EDR Implementation Team and local IT staff?

Yes No

4. Does the site have a signed BAA with Team EDR ?

Yes No

5. Does the site have a signed EULA with Team EDR ?

Yes No

6. Is your domain the IHS "D1" domain?

Yes No

What is the name of your locally administered domain?

Other Information

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