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St. Peter’s iPad Raffle Entry Form

 

All St. Peter’s University Hospital physicians attending the MDS/Allscripts hosted breakfast October 25th are eligible to enter a raffle for a brand new Apple iPad 2! Enter below for your chance to win!


 


Name
Title
Name of Practice
Subspecialty
Email Address
Phone Number
Are you currently using an EMR?
Are you looking to implement a fully functional EMR...
Are you eligible for Medicare and/or Medicaid EHR Incentive Programs?
Would you be interested in a free demo of Allscripts MyWay?
[If you answered "yes" above] - Do you prefer an onsite or webex demo?

TERMS & CONDITIONS

You may enter through submitting this raffle entry form online, or at the event itself on October 25th, from 7AM-10AM. Paper entry forms will be available. Physicians [both full and part-time] from St. Peter’s University Hospital are eligible to win the iPad. The prize to be awarded through this drawing is a 16GB iPad 2. Subject to the rules and conditions of this drawing, only one iPad will be awarded. Once the eligibility of the winner has been verified, the iPad shall be delivered via UPS to the address provided by the winner. MDS/Allscripts reserves the right to modify, change or amend the rules at any time and for any reason.