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Available Forms

Add Link to Web Page AJB Use Only-Neurology Task AJBMD Video Room Notification AJBMD-Nurse Ready for Neurology Case AJBMD-Quick Mobile Text from Home Page Apractis Clinic Library Access Request Confirm Updox Login Family Available for Consult Info Now Family Contact Information General Neurology Request-with CCC contact Go To Assist Code Request NeuroDox--Create New User within Virtual Clinic Notify Andrew Barbash, MD that Patient is Ready NowDox-ED Neuro Triage Form NowDox-Nurse Ready for Neurology Case Nurse/Care Manager Secure Message for Andrew Barbash, MD Other Hospital or Facility Neurology Advice (Physician/Mid-Level Use Only) Patient/Family Caregiver Registration Patient/Family Caregiver Request Virtual Care Physicians/Mid-Levels Secure Message for Andrew Barbash, MD Podio Access Request Radiologist Report of Neuro Imaging Setup Zoom Room Notification Form ShareFile Secure Folders Registration SOC Consult Center Message for Dr Barbash TEST-Acute Stroke Quick Intake TEST-Neuro 911-Acute Stroke TPA NOT likely TEST-Neuro 911-TPA Exclusion List TEST-Neuro 911-TPA Probable TESTING-General Neurology Request TESTING-Hospital Neurology Request-NeuroDox Form Updox Clinician Invite Request-General Neurology Updox Connect Request Updox Healthcare Professional Registration Updox User Login Request-SOC Physician VC-Colorado-Centura Teleneurology Message Form (Physician/Mid-Level Use Only) VC-Florida-(Physician/Mid-Level Use Only) VC-Holy Cross Clinics (first time user) VC-Holy Cross Clinics (Returning User) VC-Maine VC-Massachusetts-Neurology VC-Neurology-Curbside Advice VC-Neurology-Lake Norman Clinic VC-North Carolina VC-Virginia (Physician/Mid-Level Use Only) Virtual Care Primary Care Patient Registration Virtual Clinic HelpDesk Virtual Clinic-Request New Member Invite Request Entry to My Zoom Video Room-AJBMD Virtual Care Request (Physician/Mid-Level Use Only) Web Message for Dr Barbash
TEST-Neuro 911-TPA Probable

Neuro-TPA /Intervention Probable

DEMO TESTING...PHYSICIANS ONLY. When you complete this simple form from your mobile phone or any device, it appears in a secure clinical inbox for team review.

Check all that apply
If this is an acute stroke case please click all that are relevant

TPA Discussion with Patient/Family Preference

If we are going to discuss IV TPA with a patient and their family, do you prefer to be called on the phone first, before we discuss TPA, or to be brought into the room by the nurse and participate together on video in the discussion?

You will get a confirmation message to your PERSONAL cellphone

IF YOU DO NOT HEAR FROM ME WITHIN 10 MINUTES Please call the CCC Consult Center to see if someone else is available



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