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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 PERSONAl/MY FAMILY ONLY-From Ellie to Andy 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 CCC GN Intake Form SOC CCC-Message for Dr Barbash TEST-Acute Stroke Quick Intake TEST-Neuro 911-Stroke but TPA less likely TEST-Neuro 911-TPA Exclusion List TEST-Neuro 911-TPA Probable TESTING-General Neurology Request TESTING-Hospital Neurology Request-NeuroDox Form TESTING-Neurology Followup 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
VC-Holy Cross Clinics (Returning User)

Non-Urgent Neurology Virtual Care Request

ONLY USE THIS FORM IF YOU HAVE ACCESSED THIS SERVICE BEFORE AND ENTERED YOUR MOBILE PHONE AND EMAIL. This form assumes you have used this service before and we already know your mobile phone and email. It is intended to minimize the amount of data entry for those who have used this service before

This service is currently offered by a small team of neurologists privileged at one of these facilities
 
If specific to a patient, you can enter it here
 
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