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Center performance
analysis

Doctor and Patient

Please complete the form below.

CENTER INFORMATION

Center Name

Hospital Name

Select an Address

Contact Name

Contact Email

Year Center Officially Opened

Year HBOT Officially Opened (optional)

Electronic Medical Record Name/Version

REPORTS

Monthly new patients last 12 months wound care

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Monthly hyperbaric dives last 12 months

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Center charge master

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Report of deparment revenue and expenses by month last 12 months

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Thanks for submitting! Our team will contact you if we require further information to complete your audit.

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