i-MD
Home
/
About
/
Support
What is i-MD
Billing Management
Electronic Health Records
Contact
FAQs
Request Support
Pay Bill
Request Support
Please complete the following information and hit submit (below form). We’ll get back in touch with you as soon as possible. Thank you.
First Name
Last Name
Email Address
Company Name
Phone number (include area code)
Mailing Address
City
State
Zip
Best time to reach you by phone (AM/PM)
Please provide a brief write up of any questions that you may have using the box below
To help prevent automated submissions, please enter the letters in the image below.
Reload Image
Items in
RED
are required.
Submit
Reset