eReferral Specialist Onboarding Form

Before you Continue

This form requests Onboarding Services for a clinic that is not currently using Ocean.

If you are looking for Technical Support, need help onboarding a single user to an existing Ocean site, Training, or have any other inquiries regarding Ocean, please use the

General Inquiries & Technical Support Form: (https://www.referralsns.ca/ask)

Date

yyyy-mm-dd

Your Name (Submitted By)

Clinic Name.

What is your practice specialty?

Clinic Administrator/Contact Name

Clinic Administrator/Contact Email

Clinic Administrator/Contact Phone

Phone

Specialist(s) Name

Specialist(s) Email

Which EMR do you currently use?

Do you share an EMR with other providers?

Send me a copy of my responses

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