Add New Practitioner BMI/Barwon Health

Add New Practitioner or New Practice Barwon Health

Completion of this form will directly update your practitioner information registered with all Barwon Health departments including BMI, Medical Resource Unit, Andrew Love Centre, Cardiology, Neurology and GP Liaison Unit.

Practitioner Details

Title:

First Name:*

Surname:*

Provider Number:*

Profession Type:*

Profession Specialisation:*

Add another practitioner

Practice Details

Practice Name:*

Practice Manager (or primary contact):*

Practice Manager Email:*

Street Address:*

Postal Address:

Suburb:*

Postcode:

Phone Number:*

Facsimile:

Practice Email:*

Set Up

How do you wish receive Barwon Health correspondence/BMI (radiology) results:

Electronically via PULSE

Facsimile

Other

Modify Recipient Document Preferences (Specialists only)

Please indicate the document types you wish to receive from Barwon Health.

Discharge Summaries:

Operation Notes:

Outpatient Letters:

Electronic Image Viewing

Barwon Health can provide secure access to view images and reports online from Barwon Medical Imaging, allowing twenty-four hour access to patient information.

Do you have Synapse loaded on your computers to view images on line? Yes No

Do you have a Synapse username and password? Yes No Unsure

A Barwon Medical Imaging representative will call you to discuss installation/access if required.

Contact at your practice for installation:

Verification

Add New Practitioner or New Practice Barwon Health

Add New Referrer Details