All of these forms may be accessed using Adobe Reader.

Original signatures are required on almost all forms. Please complete the form on line, print, sign and fax back to MDERA at 1-866-362-2790 for processing.

 

· How to Join MDERA and Activate/Deactivate your EMIS User Account

Please, download this document for instructions on how to join MDERA and activate/ deactivate your EMIS user account

· MDERA User Account (Physicians & Clinical Admin Staff)

For use of all MDERA Physicians, their clinical and administrative support staff

Note to MANAGERS: If you are unable to register this user in WBT please, download this separate form: Emis WTB Courses & Prerequisites

· MDERA Confidentiality Agreement

User Access and Confidentiality Agreements for use of all MDERA Physicians, their clinical and administrative support staff

· Requests for Database Search Request Form

Meant for use with the Data Research Agreement contained in the Privacy and Security Policy

· E-Lab Application

For Physicians: request to have Electronic lab results sent directly to the physicians EMR

· UCMG Historical Consultation Letters

For Physicians: request to download Historical Consultation letters by UCMG  Transcription — to be forwarded back to the physician and uploaded into the patient files

· EMIS Profile Set-up

For Physicians: to set-up UCMG transcription profile

· AHW FOB Application Form

For Physicians: application to acquire a FOB From Alberta Health and Wellnet to gain access to the EMIS software from remote environments outside of CHR and UofC sites

· Alberta Netcare Portal User Registration

For Physicians: to access Netcare Portal

· Referring Physicians

For Billing Clerks: information form to be submitted to Access Office