WellSky Enhancement Request€¦ · Web viewWellSky 11300 Switzer Road Overland Park, KS 66210...

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WellSky Enhancement Request Form Behavioral Health & IDD Providers WellSky Enhancement Request Form WellSky 11300 Switzer Road Overland Park, KS 66210 913.307.1000 FAX 913.307.1111 www.wellsky.com

Transcript of WellSky Enhancement Request€¦ · Web viewWellSky 11300 Switzer Road Overland Park, KS 66210...

Page 1: WellSky Enhancement Request€¦ · Web viewWellSky 11300 Switzer Road Overland Park, KS 66210 913.307.1000 FAX 913.307.1111

WellSky Enhancement Request Form

Behavioral Health & IDD Providers

WellSky Enhancement Request Form

WellSky11300 Switzer Road

Overland Park, KS 66210913.307.1000

FAX 913.307.1111www.wellsky.com

Page 2: WellSky Enhancement Request€¦ · Web viewWellSky 11300 Switzer Road Overland Park, KS 66210 913.307.1000 FAX 913.307.1111

Copyright © 1997-2020 WellSkyAll rights reserved.

The software contains proprietary information of WellSky; it is provided under a license agreement containing restrictions on use and disclosure and is also protected by copyright law.  Reverse engineering of the software is prohibited.

Due to continued product development this information may change without notice.  The information and intellectual property contained herein is confidential between WellSky and the consumer and remains the exclusive property of WellSky  If you find problems in the documentation, please report them to us in writing.  WellSky does not warrant that this document is error-free.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior written permission of WellSky

Microsoft Word, Microsoft Office, Windows®, Windows 2000™, Windows NT™,  and Windows XP™ are trademarks of the Microsoft Corporation.

 

 

WellSky11300 Switzer RoadOverland Park, KS 66210

913.307.1000FAX 913.307.1111Website: www.wellsky.com

Page 3: WellSky Enhancement Request€¦ · Web viewWellSky 11300 Switzer Road Overland Park, KS 66210 913.307.1000 FAX 913.307.1111

WellSky Enhancement Request*Please create and attach this completed form to a Salesforce Case

Date of Request: Click here to enter a date. Salesforce Case #: Click here to

enter text.

MCO/Provider: Click here to enter text. Requesting Department: Click here to

enter text.

Staff Contact Name: Click here to enter text. Staff Contact Phone #: Click here to

enter text.

Area of Enhancement: Module: Click here to enter

text.

Tab: Click here to enter text. Tile: Click here to

enter text.

Please Explain the

Issue:

Click here to enter text.

Suggested

Enhancement:

Click here to enter text.

Enhancement Impact on

Other Modules:

Click here to enter text.

Requested Priority: ☐ Low ☐ Medium ☐ High

MCO/Provider

Approval:

Department: Click here to enter text.

IT Director: Click here to enter text.

UG Review Date: Click here to enter a date. WellSky Approval Date: Click here to enter a

date.

Target Due Date: Click here to enter a date. Build Number: Click here to enter

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text.

Approved Priority: ☐ Low ☐ Medium ☐ High

Review Comments: Click here to enter text.