Title:

First Name: *

Surname: *

Provider Number: *

Profession Type: *

Profession Specialisation: *

Practice Name: *

Practice Manager (or primary contact): *

Practice Manager Email:

Street Address: *

Postal Address:

Suburb: *

Postcode:

Phone Number: *

Facsimile:

Practice Email:

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

Electronic Result Distribution (PULSE)

Facsimile

Other

Yes:

No:

Unsure:

Barwon Health is moving to distribute all of its results electronially via pulse.

PULSE is utilised to distribute:
Barwon Medical Imaging results
Barwon Health:

• Discharge summaries
• Operation notes
• Outpatient letters
• Admission and Death Notifications (coming soon)

Facsimile Number:

Synapse (PACS) is a software package which enables medical practitioners 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:

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