Updating your provider/prescriber information now simplified
 
Alberta Health Services has implemented a form to Request for Provider/Prescriber Set-Up in Health Information Systems. The form allows community providers to advise different groups within AHS as well as affiliated organizations of new information or changes to:
  • Provider/prescriber name; professional and Connect Care identifiers; practice location(s); locum status
  • Clinic/location/client/office name, demographics (address, contact information), etc.
  • Preferred method for receiving results and other information from AHS and affiliated organizations
The new single form replaces the Alberta Precision Labs Healthcare Provider Information and Set Up forms, the DynaLIFE Healthcare Provider Setup Request Form and the eDelivery Service Request Form. It will support centralized operational processes for the maintenance of provider master data, including identity data and external venues where provider/prescribers deliver care.
 
How this affects you
  • Update clinic and provider information with as much notice as possible.
  • Replace any saved versions of forms with the new one and point all links to the new form. A completion guide for users of the form is also available.
  • This smart form can be completed and submitted online, printed and faxed to 1-780-644-1792; or printed, scanned and emailed to AHS.Provider_Requests@ahs.ca.
  • eDelivery users
    • Requests from clinics using eDelivery are still required to include their EMR vendor in the requests process, to provide EMR-specific information with each request. EMR vendors remain able to submit the form on behalf of their clients.
    • Paper Suppression requests must still use the Paper Suppression Form.
Questions? Need more information?
If you have questions about this new process, please contact AHSProvider.Requests@ahs.ca. 
For more information, please see the July 6, 2021 Memorandum from AHS.
    

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