fasten-onprem/.github/ISSUE_TEMPLATE/provider-request.yml

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name: Provider Request
description: Request a new institution/clinic/insurance provider to be added to Fasten
title: "[Provider Request]: "
labels: ["provider", "enhancement"]
projects: ["fastenhealth/fasten-onprem"]
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assignees:
- AnalogJ
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body:
- type: markdown
attributes:
value: |
Thanks for taking the time to request a new Provider.
Before you submit this request, please make sure that you've searched the existing issues to see if your provider has already been requested.
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- type: input
id: contact
attributes:
label: Contact Details
description: How can we get in touch with you if we need more info?
placeholder: ex. email@example.com
validations:
required: false
- type: input
id: provider-name
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attributes:
label: Provider/Institution Name
description: What is the name of this Institution?
placeholder: ex. Humana/Kaiser/John Hopkins
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validations:
required: true
- type: input
id: provider-website
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attributes:
label: Provider/Institution Website
description: Please share a link to the provider's website.
placeholder: ex. https://www.humana.com/
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validations:
required: true
- type: input
id: provider-ehr
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attributes:
label: Provider EHR Platform
description: If you know the name of the EHR platform that this provider uses, please share it.
placeholder: ex. Epic MyChart, Cerner, Allscripts, etc
validations:
required: false
- type: textarea
id: additional-info
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attributes:
label: Anything else we should know?
description: Please share any additional information or links that you think would be helpful.
validations:
required: false