Provider
Your facility, taken from Organization settings.
Add the facility type. Facility Type is required when a facility name is entered.
Provider organization
Pre-filled from Organization settings
From Organization settings.
Required when a facility name is entered.
From Organization settings.
Enter the facility type to continue.
Additional provider details
- Organization type
- Hospital (from Organization settings)
Type of healthcare provider (hospital, clinic, etc.)
Requesting practitioner's specialty (sent only when a practitioner is included)