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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 Secure Messaging Registration with Andrew Barbash, MD 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
TEST-Neuro 911-Stroke but TPA less likely

TESTING--Acute/Subacute Stroke but TPA NOT likely

The purpose of this form is to help a hospital based physician to quickly inform a remote specialty service about a patient with a suspected stroke, for whom prompt evaluation will still be helpful, but for whom TPA is NOT anticipated. Use this form if you have an acute stroke case that you are pretty certain is NOT likely to get TPA" based on the data and information you have. Do NOT use this form for "Possible or Probable TPA candidate" If any of these boxes are checked then it is unlikely that you are requesting an evaluation to administer TPA....The request might be for urgent neurologic assistance but not for TPA administration.

 
 
 
 
 
 

Your Personal Cellphone (for text reply)

Please know that a neurologist will still attempt to consult with you promptly. This form is merely to help detemine if the need is so urgent that it would be necessary to start a direct video consult before other information is accessible

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