Electronic Reports Download
Clinical Software to View Patient Data
*
Please Select
Best Practice
Genie
Medical Director
Prac Soft
Zedmed
Other
If other what is your Clincal Software?
How many referrers would you like to sign up?
Please Select
1
2
3
4
5
6
7
8
9
1. Referrer Name
Specialty
Provider Number
2. Referrer Name
Specialty
Provider Number
3. Referrer Name
Specialty
Provider Number
4. Referrer Name
Specialty
Provider Number
5. Referrer Name
Specialty
Provider Number
6. Referrer Name
Specialty
Provider Number
7. Referrer Name
Specialty
Provider Number
8. Referrer Name
Specialty
Provider Number
9. Referrer Name
Specialty
Provider Number
Practice Details
Practice Name
*
Practice Address
*
Practice Email Address
*
example@example.com
Practice Contact Name
*
Telephone Number
*
Fax Number
*
Do You already have a Promedicus net connection?
*
Yes
No
Do you have a Technical Contact for your practice?
*
Yes
No
Technical Contact's Name
Technical Contact's Email
Telephone Number
Please circle the operating system listed below that your computer (s) use:
Server
Windows 8
Windows 2016/2019
Windows 10
Mac OS
Installation Options
I would like to download the software and have my technical contact perform the installation
I would like to have Promedicus contact the practice contact to perform the installationremotely via Team Viewer
I would like to have Promedicus contact the practice contact to guide them through the install
TERMS OF ACCEPTANCE OF NOMINATION
I/We, the Practice named above, accept your nomination that I/we be appointed as a registered user of the Promedicus.net Secure Email System. I/we understand that this will require my/our agreement to install the Promedicus.net Client Software on my/our computer. I/we understand that I/we may either accept or reject the installation and acceptance will be on the terms of the “Licence Agreement for Use of the Promedicus.net Secure Email System by Nominated Recipient”. I/we agree that any person who installs the Promedicus.net Client Software on my/our computer does so as my/our agent on my/our behalf. These terms may be viewed by accessing http://www.promedicus.com.au/terms-of-use or by reading the licence agreement displayed when installing the“software"
Date
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
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