Andrew Barbash, MD - Publicforms

Available Forms

Apractis Clinic-Request New Member Invite Barbash Network-Register Consult Documentation-Neurology-Andrew Barbash, MD Consult Request-Community Clinic Consult Request-Putnam Hospital (NY) Consult Request-Univ of Md St Josephs Copy of Join Us-Including Specialties Family Available for Consult Info Now NeuroDox-Request a Mobile Video Link NowDox Request Confirmation NowDox-Add Room Link Other Hospital or Facility Neurology Advice (Physician/Mid-Level Use Only) Patient Confirm Video Visit Time Patient Info Request Send to Provider 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 Schedule a Virtual Care Visit with AJBMD ShareFile Secure Folders Registration Team Meeting TESTING-General Neurology Request TESTING-Hospital Neurology Request-NeuroDox Form TESTING-Neurology Followup Virtual Care Primary Care Patient Registration WAFCC-Admin Contact Form Waiting Room-Dr Vu Waiting Room-Test Specialty WebForm-Add Your Hospital to Our List WebForm-Availability-Neurologist WebForm-Consult Request for Dr Barbash-Neurology Telemedicine WebForm-Meet Dr Barbash by Video WebForm-Register with Barbash Virtual Care WebForm-Request to Enter Webinar Meeting WebForm-Specialist Registration for Barbash Virtual Care WebForm-Updox ID Request for Barbash Neurology Team WebForm-Waiting Room-Neurology Request Entry to My Zoom Video Room-AJBMD Web Message for Dr Barbash

Waiting Room-Test Specialty

Secure Form to Request Entry into a Provider's Virtual Waiting Room

THIS IS FOR TESTING AND DEMONSTRATION PURPOSES ONLY.....For direct use by nurses, mid-levels, physicians or other healthcare professionals to enter the virtual waiting room for a provider or specialty team. ANY device can be used. This is fully HIPAA-compliant, does not require any software to install and does not require any IT support

Your Name *

First AND Last Name Please

Your Mobile Number (Smartphone) *

We MUST be able to communicate by SMS text to a smartphone for reliable contact.

Clinic, Hospital or Facility *

Where should the room link be sent to? *

My mobile phone

My email address

No preference

You decide if you prefer to do the video meeting from your mobile phone or your computer/tablet

If you selected mobile to connect, skip right to the SUBMIT button

Email (Optional)

IF you will want to meet on your computer or tablet instead of a smartphone, then we can send the link to your email. If that is preferred, then enter your email. Otherwise leave this blank

Comments (Optional)

If you want to provide the patient name or any other relevant information that would be helpful to the visit, this is all secure and arrives in our team inbox.

We will respond with a unique meeting link. This will enter you in a waiting room, we are notified, and then will start the video session.

* Required field