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Information Request

We're happy to talk with you about how we can help you in your medical practice.  You may reach us at the following address:

Next Generation Health Services
Attn: Mark Nielsen
5656 S Power Rd Unit 126
Higley, Arizona 85236
(480) 545-9689 x205; fax (480) 545-7349

You may also submit the request form below to help us better identify your interest and needs.

About Your Practice

This information is used only in our communication with you and is not released to other organizations without your permission.

Practice Name
*
Street Address
City
 State
 Zip
Contact Name
*
E-mail Address
*		 Phone Number
*		 Fax Number

Services You Are Interested In

This information helps us identify your interests and needs.

Billing & Collection
Referrals
Credentialing		 Transcription
Scheduling
Payroll/HR		 Marketing & Outreach
Medical Staff Training

Your Comments/Questions to NGHS

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