ModMed Research Panel Volunteer
Contact Information
Hi there! Thank you for your interest in design research at ModMed. Please fill out the below information for the client whom is interested in becoming a volunteer.
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1.
Client First Name
(Required.)
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2.
Client Last Name
(Required.)
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3.
Email: Please provide a direct email address, rather than a general email address such as "info@practicename.com." These emails will be used only for research with ModMed's UX team.
(Required.)
4.
Job Title
5.
Primary Job Function
Executive Leadership
Practice Administration or Other Management
Financial - patient claims and billing
Office staff
Clinical support staff
Clinical provider (MD, DO, PA, NP)
