Please complete this short form as soon as possible so we can confirm which devices are used to access HCBSBilling CRM.

#1. Which type of device do you use? (Required) *

• Apple iPhone
• Android Phone

#2. What is the make and model of your device? (Required) *

(For example: iPhone 14 or Samsung Galaxy S8)

#3. If you use an iPhone, is it an iPhone 8, iPhone X, or an older model? (Required for iPhone users)

• YES
• NO
• Not Sure

#4. What iOS or Android version is your device running? (Optional)

iPhone #1. device?

Custom Captcha *

=

Submit