Offsite PACS access for Patient Imaging

Applicant Details

First Name *

Last Name *

Email Address *

AHPRA Number *

Mobile Number *

Provider Number *

Do you know your Healthcare Provider Identifier - Individual (HPI-I)? *

YesNo

Please provide your Healthcare Provider Identifier - Individual Number *

A healthcare identifier is a unique number that ensures healthcare providers can accurately match records to the person they are treating. It will take longer to validate your identity if not provided.

For more information on finding your HPI-I visit the Services Australia Website.

Do you have an Active NSW Health Stafflink ID *

YesNo

Stafflink ID *

NSW Health employees can access SNSW MLHD PACS via https://pacs.gsahs.health.nsw.gov.au/. If you're unable to access the PACS via this link, please complete the form.

Practice Details

*Please use the practice you most frequently attend

Practice Name *

Practice Email Address *

Practice Town *

Practice Phone Number *

Practitioner Agreement

By selecting the below check boxes, you agree to the below statements

I accept full responsibility for images that I have been granted access to by NSW Health. I understand that I must only access these images using my own account and that my account must not be shared. I also understand that my password must be kept confidential. *

I agree not to disclose any information that may assist any person to gain access to MLHD & SNSW LHD computer systems.

*

I acknowledge that I am bound by The Privacy Act 1988 (Privacy Act) and will treat all patient information as private and confidential.

*

By selecting the below check boxes, you have read and agree to the following policies:

PD2009_076 - Use & Management of Misue of NSW Health Communications Systems *

PD2020_046 - Electronic Information Security Policy *

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