Part 3, Chapter 7: Manual Appendix B
REQUEST FOR SOFTWARE MODIFICATION
Date:_______________________________
Requested By:________________________
Station:______________________________
Area: _______________________________
PSG Representative: __________________
Description of Problem:
Description of Request:
Justification of Request:
Action: (To be completed by Chairperson, IHS PSG)
This form should be completed for all software modification requests. Forward the form to the Chairperson, IHS Pharmacy PSG, through the Area Pharmacy PSG Representative. Use the back of the page if necessary.
