Dentrix Enterprise Professional Services are a great way for organizations to create custom features or reports specific to their organization’s unique needs. This form should be used to request in detail your custom feature or report.

Tell us what your request is, the issue that it will solve, and the design you had in mind that will function in your current workflow.

• Please make sure that no patient information (PHI or PPI) is included when submitting requests
• Please only put one request on a form.
  • If you have multiple requests, submit multiple forms

PST will provide, via email, a “ballpark’ level of effort in one of these categories; Small, Medium, Large, Very Large to develop your request.

Office Name*

Office Address 1*

Office Address 2

Office City*

Office State*

Office Zip*

Office Contact*

Contact Email*

Contact Phone*

Practice Type

Customer Number*

Current Dentrix Enterprise Version*

SQL Version*

Please provide enough information to make it clear for someone outside of your organization to understand exactly what is being requested and for what purpose. The form will grow as the detailed information is typed in, so feel free to use additional pages. If you would like to include screen shots, supporting documents, or additional information, please email separately to pst@dentrixenterprise.com. Be sure to include your office name and the request description in the email.

Please answer, in detail, the following 3 questions that should help in providing enough information to allow us to provide a level of effort estimate:

What is the issue this request should resolve?*

What is the request?*

How do you see the request working in your current workflow?*
(In order to find a solution that incurs the least amount of cost to the customer, integrates with current functionality, and meets the needs of the customer, Dentrix Enterprise Professional Services Team makes an effort to explore all options and possible solutions in regard to the customer’s request. Often it is found that customers have been accustomed to a variety of different business models and may not realize their goals can be accomplished just as efficiently through using alternative processes and features that are already available. Although there are many factors that contribute to development decisions, customer perspective is necessary to ensure that the best solution is provided.)

©2019 Henry Schein One, Inc. Henry Schein One, Inc. makes no representations or warranties with respect to the contents or use of this documentation, and specifically disclaims any express or implied warranties of title, merchantability, or fitness for any particular use. The information on these pages is provided for informational purposes only and is subject to change without notice. Any risk arising out of the use of the information on these pages shall remain with the reader. In no event shall Henry Schein One, Inc. or its subsidiaries be liable for any direct, consequential, incidental, special, punitive or other damages whatsoever (including, without limitation, damages for loss of business profits, business interruption or loss of business information), arising out of or in connection with the availability or use of the information contained in these pages, even if Henry Schein, Inc. or its subsidiaries has been advised of the possibilities of such damages.