Having an issue sending a fax?

Issue with Faxing or Interface?

Please use the form below and a Help Desk ticket will be created to resolve the problem.
Name of person reporting the issue

First NameLast Name
Phone number of person reporting the issue
Please enter a valid phone number.Format: (000) 000-0000.
Email Address of person reporting the issue
example@example.com
Name of practice/clinic experiencing the issue
Your information is securely transmitted and protected. We use industry-standard encryption to ensure your data remains safe and confidential at all times.
- Are you having a problem sending a fax to South County Health?
- What South County Health department are you trying to send the fax to?
- What fax number are you sending the fax to?
- What fax number are you sending from?
- Are you faxing from an Electronic Health Record system?
- Name of EHR
- When did you last try to send the fax?
  
  MonthDayYear
  Date
- Time
  
  Hour Minutes
  
  AM/PM Option
- What happened when you attempted to send (i.e. busy signal, error)?
- What you were trying to fax to us (i.e. referral, lab test order)?
- What is the frequency of this issue occurring
- Have you reported the issue to your IT support /department?
- Please provide the name and phone number of your IT contact so we can work together to help solve this issue:
- Please provide an example of a missing result (name, DOB, result type)
- Please provide any other information you feel will be important for us to know about this issue:
- It is recommended that both sender and receiver evaluate IT systems when working through faxing issues:
- Are you having a problem receiving faxes from South County Health?
- What type of documents are you not getting? (i.e. lab results, imaging)
- Which provider(s) are reporting not getting the faxes?
- What is the fax number the documents should be sent to?
- What is the frequency of this issue occurring (daily, once in a while)?
- Do you receive faxes on a fax machine or in another system?
- If other system please enter name (i.e. Epic, ModMed, etc)
- Have any changes occurred recently (i.e. provider new to practice, new system installed, etc)
- Have you reported the issue to your IT support/department?
- Please provide an example of a missing result (name, DOB, result type)
- Please provide the name and phone number of your IT contact so we can work together to help solve this issue:
- Please provide any other information you feel will be important for us to know about this issue:
- Are you having a problem with interface from South County Health?
- What system is missing the data (Lifepoint, EHR)
- What is your Electronic Health Record system? (if answered EHR above)
- What type of results are you not getting? (i.e. lab results, imaging)
- What is the frequency of this issue occurring (daily, once in a while)?
- Please provide an example of a missing result (name, DOB, result type)
- Please provide the name and phone number of your IT contact so we can work together to help solve this issue:
- Please provide any other information you feel will be important for us to know about this issue:
- After you click submit a work order will be placed with the SCH Help Desk. Follow up questions from SCH IT will be sent via email with a work order number.
Should be Empty:

Issue with Faxing or Interface?