Quality Data Processing, Inc.

System Information Request Form

Name:
Company:
Address:
City:	ST:	Zip:
Phone:
Fax:
Email:

Which of the following Quality Data Processing software systems are you interested in (please check all that apply)?

MEDIC-AID® HCFA1500 Claims Submission
MEDIC-AID® Community Based Claims Submission
PRI~MED2000® Medical Office Management
MAGNA-MED® Clinical Office Management
MAIL LIST MANAGEMENT CASS certification & mail list management
OFS® Order Fulfillment System
PRO-PAY® Payroll System
UMS® Union Management System

Please tell us about any special needs your firm may have.

Quality Data Processing, Inc.

1165 Dicus Mill Road
Millersville, Maryland

local phone: 410-729-2442
toll free phone: 866-321-0765
Email: Q.D.P.