Submit a request

These forms are ONLY for inquiries from Healthcare Facilities. If you are a Healthcare Professional, you can contact our Support team directly through the “Start a Chat” option in your Clipboard Health app. If you have trouble logging in, please select “Technical Issues” from the dropdown below.

Please choose your issue below

Your email address

Subject

Are you a Healthcare Professional or a Healthcare Facility?

Details on Documents Request: (optional)

Which facility type is most applicable to your Clipboard shifts?(optional)

What was the facility type for the shift in question?(optional)

Do you experience a pop-up noting missing document requirements when you try to book?(optional)

What date was the shift scheduled for? (must use format MM/DD/YY)(optional)

Shift Block

What was the time block for your shift?

Name of the Facility in question?

Other Reason for Contact(optional)

Description

Please enter the details of your request. A member of our support staff will respond as soon as possible.

Attachments(optional)

Add file or drop files here