Report an Issue

Required fields are marked with an asterisk

Email confirmation to(required)

Summarize the problem(required)

High level sentence or title that highlights the issue

Customer/Organization Name(required)

Facility Name(required)

Enter Facility Name

Patient Name(required)

Enter Patient Name if Applicable. Otherwise enter N/A

Enter Discipline Name

Physical, Occupational, Speech Therapy (or multiple)

Describe what happened and how it occurred(required)

Please include any details that will help find or re-create the issue. This includes steps taken in the Via Cura system (or date sent to Via Cura from an integration). Also, timing or order of steps that taken before having the issue can be helpful.

Attachment

Drag and drop files, paste screenshots, or browse

How urgently does this need to be fixed?

Critical = System wide issue preventing use of the system, High = prevents or restricts use or accuracy for your and other faciltiies/users, Low=Issue but impacts one or a few patients or doesn't prevent other work, Low = Not preventing work

How big of an impact is the problem to you or the organization?