Skip to Main Content
Optalis I.T. Helpdesk
Login
Register
Optalis Healthcare
Optalis I.T. Helpdesk
Submit a ticket
Adverse Event Reporting
Submit a Support Request
Required fields are marked with
Requestor Name:
Email:
Add Cc
Cc:
Separate each email with a comma.
Building:
- - Click to Select - -
Abbyshire Place
Allen Park
Ann Arbor
Belle Fountain
Bloomfield Hills
Canal Winchester
Canton
CP Clio ALF
CP Grand Rapids ALF
CP Milford ALF
CP Mill Run ALF
CP New Albany ALF
CP Pickaway Manor ALF
CP Riverview ALF
CP Shorepointe ALF
CP West Bloomfield ALF
Dearborn Heights
Evergreen
Fountain Bleu
Four Seasons
Grand Rapids
Greenfield
Grosse Pointe Woods
Ionia
Kent Crossing
Kingsford
Lakeland Center
Leonard
Mill Run
Monterey
Muskegon
New Albany
Pickaway Manor
Riverview
Shelby
ShorePointe
St. Francis
Sterling Heights
The Grand - SNF
The Grand - ILF
Three Rivers
Troy
West Park
Whitehall
Woodward
Wyoming
Corporate
Amber Hospice
Rivetus Homecare
Resident MR#:
Adverse Event Type:
- - Click to Select - -
Abuse - all types
Equipment Failure that caused injury/death
Pressure Ulcers
Theft - over $1,000
Unusual Events
Message:
Suggested knowledgebase articles:
Attachments:
Add file
File upload limits
SPAM Prevention
Type the number you see in the picture below.
Submitting, please wait...
(
)