Healthcare Processing Solutions (HPS) \ INQUIRIES

Tell us a little bit about yourself, and we'll contact you to discuss what HPS can do for you.

		\ company name

		\ contact name

		\ address Include city, state, and ZIP code.

		\ telephone (with area code)

		\ fax (with area code)

		\ email address

		\ comments Use this section to tell us about any special needs your business may have.

	DME Pharmacy Billing Service Mail Order Physician Other	\ business type Check all that apply to your business.

		\ last question How did you hear about HPS?