Add New Practitioner or New Practice

Completion of this form will directly update your registered practice information with Barwon Health.

Information submitted may be shared with Western Victoria Primary Health Network for the purpose of local database correlation.

"*" indicates required fields

Practitioner Details

Title*

First Name*

Surname*

Provider Number*

Profession Type*

Profession type: (Eg. Doctor/Physio)

Profession Specialisation*

Profession Specialisation: (Eg. Cardiologist)

Practice Details

Practice Name*

Practice Manager (or primary contact)*

Practice Manager Email*

Street Address*

Postal Address

Suburb*

Postcode

Phone Number*

Facsimile

Practice Email*

Practice Software

Electronic report delivery

From 2024, Barwon Health will be moving to utilise HealthLink secure messaging as our preferred method of delivering patient reports to your practice.

To enable this, please provide your HealthLink EDI below.

Practice HealthLink EDI

Please ensure you update any new provider details with you practice HealthLink account, as well as the National Health Services Directory (NHSD)

To register for Healthlink secure messaging go to https://au.healthlink.net/

CAPTCHA