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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
TESTING-Hospital Neurology Request-NeuroDox Form

Request Neurology Consult

Pilot program of a direct neurology triage form for use directly by physicians or mid-level providers . This is not for use by unit clerks or support staff. It is intended for directly conveying to the neurology coverage team what you need and when.

PLEASE NOTE...in a live program there would be a separate form just for YOUR hospital so you would not need to enter this separately. That form would be automatcially delivered securely to an Updox Team Inbox. The Neurologists who are credentialed at your facility would all have access to that team inbox queue and whoever is working on shift or available to assist with extra needs would be notified on their mobile phones, access the queue and respond back to you.
 
I must be able to send you back an SMS text message. If you do not have a mobile phone able to accept a text message please do not use this form.
 
 
 
Please check all that apply, which will help the neurologist rapidly triage the case and make sure your needs are met
 
 
 

Please make sure your staff calls the case into the Consult Coordination Center so that it can be logged and also assigned out accordingly. The SOC Consult Center Number is 855-216-1075.

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