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Infrequent Provider Assistance Request Form
This service is to assist providers placing orders in Children's EMR. Providers may call the physician access line
(612-343-2121)
to schedule assistance prior to arrival for rounding on patient(s).
Monday - Friday 6:00AM - 8:00PM on site support analysts will be available for assistance.
Afterhours, Weekends, and Holidays - The Health Unit Coordinator, Charge Nurse, or Staff Nurse will be available for assistance.
***If the above resources are unavailable or unable to provide support, Providers can call the Help Desk for phone support at
3-2500
, in situations where patient care is dependent on orders entered into the EMR, the providers should utilize the "VORB" Verbal Order process with the assigned staff nurse.
NOTE:
*
indicates a required field
Provider Name
*
:
Contact Preference
*
:
Phone
Pager
E-Mail
Contact Number:
##### or (###) ###-#####
Email Address:
Date/Time of Arrival:
*
:
(mm/dd/yyyy)
(##:##) military time
Needed for resource planning purposes.
Specialty
*
:
Location meeting Support Resource
*
:
** Note: Please call Children's Help Desk or Children's Physician Access Line to notify support resources if schedule changes and you are unable to meet at the specified time.
Comments:
Official Training Requested?:
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Date Last Modified: 10/23/2009
