Please complete the following eMPI Merge Tool Form. The items marked with asterisk (*) are required. We will respond to your inquiry within 2 business days.


Contact Information

*Name *Department
* Phone Number * Practice Manager Email
* Email
Request Information

Did you create this duplicate patient?
*Patient First Name *Patient Last Name
* Date of Birth
*Gender
*Is it an urgent request
*Reason Specify Other
*Which system(s) are displaying a duplicate patient?










Request Comments
Cerner, eIDX, KEANE, EPIC

*MSMRN/TMP # 1 *MSMRN/TMP # 2
MSMRN/TMP # 3
BI EAGLE, SLR EAGLE, BISL IDX

*Eagle MRN/PLT/EUID 1 *Eagle MRN/PLT/EUID 2
Eagle MRN/PLT/EUID 3
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