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PrecisionCare Support Request Form
Your First Name*
Your Last Name*
Office Location*
-- Please select Your Office Location --
Administration Department
Bryant
Callowhill
Community Support
Dohrman
Fiscal Department
Greenfield
HR Department
Island
Jancey
Longo
Maintenance Department
McKeesport
McLenahan
Program
Permanent Supportive Housing
Quality Department
Royer
South Braddock
West Homestead
Your Direct Phone Number*
Your E-Mail Address*
Please provide three dates/times we can contact you regarding this problem.
What Days/Hours Are You Available?*
Remaining Characters:
500
How Urgent is this Issue?*
-- Please select the Urgency of This Issue --
No Hurry...Help me at your convenience
This is a problem, but I can still work
HELP! I can do my job, but its difficult
HELP!! I cannot do my job because of this issue
HELP!!! This is an EMERGENCY!!!
Please describe the issue that you are experiencing with PrecisionCare. Any information you provide will allow us to resolve your issue in a timely manner.
PrecisionCare Issue*
Remaining Characters:
500
Please provide the steps that you follow to access the screen(s) that you are experiencing an issue with in PrecisionCare - separated by a comma. EXAMPLE: login, mental health case records, intake, referral report
Steps To Screens*
Remaining Characters:
500
Security Image*
Enter the characters from the Security Image above:
* Required Field
