SA Pathology EDI Registration

Surgery:		*
Address:		*

	* *
Contact:	* *
Phone:		*
Email:		*

Select the software that you use:
Please provide your Gentu Minor ID: Please provide detail on the 'other' software that you use:		*

Do you have IT Technical Support? If so, please provide contact details:


List the names and provider numbers of the clinicians whose results are to be downloaded for this site:
		*

Any Further Information:

	[* Required]

EDI Results Registration