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SME Contact Information

The goal with this survey is to collect the most accurate SME information to develop comprehensive SME contact information sheet with photos.

By filling out this information, you will be providing your most current information for the BEACON team. In addition, we will create a modified version of this that will be posted on the Intranet. It won't include detailed contact information.

* Indicates required information

Please provide the following information to help us best serve you.

First Name *
Last Name *
Email *
Department *
Phone *

1. *
What hospital do you primarily work for?

If Other, please specify:

2. *
Please list the solution team you work on?

If Other, please specify:

3. *
Please list in order of priority the best way to reach you (i.e, e-mail, phone, pager).
4. *
Would you like your photo included on the SME contact information sheet?
 
 

Authentication *
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