New Practitioner Form

Register or update your details

Note: If you would like to arrange image/report access please click here

Register a new practice, add or remove a referrer or update your details using the form below.

Practitioner’s first name**

Practitioner’s last name**

Specialty**

Provider number**

Practice name**

Practice number**

Email*

Address*

Street address*

Suburb*

State*

Postal code*

How would you like to receive access to examination results?

Fax

Report only

Medical Objects

Secure electronic transmission of reports and images direct to practice software.

HealthLink

Secure electronic transmission of reports and images direct to practice software.

Please provide EDI

InteleConnect/InteleViewer

Password-protected access to images and reports. Apply for account via Qscaniq.com.au

Envision Referrer Results (ZED)

Password-protected access to images and reports. referrer.envisionmi.com.au

Practice software**

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We also accept e-Referrals. Please use the button below to access the Digital Referrals page.