High-Priority Issue Submission Form

Submit this form to report an issue of HIGH PRIORITY to the RAPC IT Support Team.

Do not submit this form for merges, addenda requests, or exam on wrong patient as there are other forms specific for those requests.

Requests of this nature are handled during RAPC business hours 8am-5pm Monday-Friday.

Requests that need to be addressed outside of regular business hours please call 541-284-4009.

Thank you.

Submitter Name: Submitter Name: First Last
Submitter's Organization:
Submitter's Phone Number: Submitter's Phone Number: - ### - ### ####
Submitter's email:
Priority:

Select priority appropriate to the issue.
Describe the Issue:

Please include details about the exam, accession, MRN, Pt. Name, DOB, steps to reproduce, device/modality ID, and any other valuable information.
Expected Outcome:

If it is not apparent in the description of the issue, please provide details on how the issue should be resolved.
Upload a File or Screen Shot:

Attach Files

Save a log file or screen shot and attach it.