(Basic details to identify the user and app version.)
Full Name:
Email Address:
Organization/Hospital Name:
App Name & Version:
Device Type:
Operating System:
Date & Time of Issue:
Is this the first time you’ve experienced this issue?
(Detailed problem reporting to understand the nature of the issue.)
Type of Issue: (Select all that apply)
Login/Authentication Failure
Messaging Not Sending/Receiving
Notifications Not Working
Audio/Video Call Problems
EHR/EMR Integration Failure
Slow Performance/Lag
App Crashes/Freezes
Missing Patient Data
Other:
Detailed Description of the Problem:
What were you trying to do when the issue occurred?
What error message (if any) did you see? (Please provide exact wording.)
How often does this issue occur?
Consistently (It happens every time)
Intermittently (It happens sometimes, but not every time)
I'm not sure / Haven't tested enough
Have you tried any troubleshooting steps?
If yes, please list the steps you have already tried and what happened:
(Helps determine if the issue is network-related or due to device settings.)
Internet Connection Type:
Wi-Fi
Mobile Data
Hospital Network
Are other apps working normally on the same connection?
Have you checked app permissions?
If yes, which permissions are enabled?
Camera
Microphone
Notifications
Other:
Is the app blocked by your organization’s firewall/VPN?
Yes
No
Don’t Know
(For authentication, or access-related problems.)
Are you logging in via:
Email & Password
Single Sign-On (SSO)
Biometrics (Face ID/Touch ID)
Other:
If using SSO, which provider?
Do you have multi-factor authentication (MFA) enabled?
Are other users in your organization experiencing the same issue?
Yes
No
Don’t Know
(For problems related to EHR sync, missing records, or API failures.)
Which EHR/EMR system are you using?
Epic
Cerner
Meditech
Other:
Is the app failing to sync patient records?
If data is missing, specify:
Patient Name/ID:
Missing Data Type (e.g., lab results, prescriptions, notes):
Have there been any recent updates to your EHR system?
Yes
No
Don’t Know
(Screenshots, logs, or screen recordings can help diagnose the issue faster.)
Description / File Name | Upload File | ||
|---|---|---|---|
A | B | ||
1 | |||
2 | |||
3 | |||
4 | |||
5 |
Any other details that might help resolve the issue.
App Support Form Insights
Please remove this app support form insights section before publishing.
Below is a detailed breakdown of the Clinical Communication App Support Form, explaining the purpose of each section, why specific questions are included, and how they help in troubleshooting and resolving issues efficiently.
Purpose:
Key Insights:
Why It Matters:
Purpose:
Key Insights:
Why It Matters:
Purpose:
Key Insights:
Why It Matters:
Purpose:
Key Insights:
Why It Matters:
Purpose:
Key Insights:
Why It Matters:
Purpose:
Key Insights:
Why It Matters:
Purpose:
Example Use Cases:
Mandatory Questions Recommendation
Please remove this mandatory questions recommendation before publishing.
These are essential for diagnosing and resolving issues efficiently.)
Why Mandatory?
Why Mandatory?
Why Mandatory?
Why Mandatory?
Why Mandatory?
Why Mandatory?
Why Mandatory?
Why Mandatory?
Why Mandatory (When Possible)?
To configure an element, select it on the form.