Physician Office Integration (POI) Activation Form Electronic delivery of Lab, Imaging and Transcribed reports Click here before registering a locum provider It is standard practice to avoid registering short-term accounts in POI. Due to their temporary nature, locum providers usually fall into this category and are not assigned their own account. If the locum provider is scheduled to cover for an extended period, please complete the following form and include the coverage duration in the “Comments” section below. Otherwise, to ensure delivery of reports to your EMR, have your locum provider include the provider they are standing in for as a recipient. Request Type Create Subscription Update Subscription Cancel Subscription Required By Date EMR Vendor Details: Vendor Name: Vendor Email:? Vendor Contact: Clinic Details: Clinic Name Clinic Contact Clinic Phone? Clinic Fax? Clinic Email? Clinic Address: Clinic Street Name Clinic City Clinic Postal Code? Practitioner Name(s)/MSP First Name Last Name MSP Operations First Name Last Name MSP Comments Please review our Privacy & Terms of Use Policy regarding collection of your personal information before completing the e-form below.
