What Do I Need to Do?

• With as much notice as possible, advise groups within AHS of new information or changes to:
  • Provider/prescriber name
  • Clinic, location or office name
  • Address, phone, fax, email or other contact information
  • Practice location(s)
  • Locum status
  • Preferred method for receiving results and other information from AHS and affiliated organizations
  • Preferred primary location for receiving results (including carbon copy (cc) results)
  • Professional and Connect Care identifiers
• Use the Request for Provider/Prescriber Set-Up in Health Information Systems Form.
• Replace any saved versions of forms with the new one and point all links to the form to https://www.albertahealthservices.ca/frm-21762.pdf
• eDelivery users:
  • Requests from clinics using eDelivery are still required to include their EMR vendor and 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

What Do I Need to Know?

The Request for Provider/Prescriber Set-Up in Health Information Systems Form replaces several forms that were previously used by community providers/prescribers to advise lab and eDelivery of demographic and results routing changes. Forms being replaced include the Alberta Precision Labs Healthcare Provider Information and Set Up Forms, the DynaLIFE Healthcare Provider Setup Request Form and the eDelivery Service Request Form.

Extensive work has been undertaken to improve the quality of demographic and routing information collected at Alberta Health Services (AHS) to protect continuity of care during Connect Care implementations across the province. This new form supports centralized operational processes for the maintenance of provider master data, including identity data and external venues where provider/prescribers deliver care.

If you have questions about this new process, please contact ahsprovider.requests@ahs.ca.

• Provider/Prescriber Set-Up Memo
• Provider/Prescriber Set-Up in Health Information Systems Form
• Form Completion FAQ