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Patient Data Solutions

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Online Clinic Signup

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We need to signup any providers here.

The basic information we require is a Provider Name, NPI Number and a signature.

If the Provider wishes to be issued portal access then we need their email address and cell phone.
These will only be used for portal authenication means, we will not spam your providers or call them up unless necessary.

if you are not authorized to sign for the provider then this form will be emailed to you after completion for you to
capture signatures.

this really needs to be a cellphone number we use SMS messaging to provide multiple layers of security and identity verification.

Provider or authorized party to sign here:

ProviderName

NPI Number

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We need to signup any contacts here.

You do not need to re-enter any providers here.

The basic information we require is a Contact Name and a signature.

If the Contact wishes to be issued portal access then we need their email address and cell phone.
These will only be used for portal authenication means, we will not spam your contacts or call them up.

this really needs to be a cellphone number we use SMS messaging to provide multiple layers of security and identity verification.

Contact or authorized party to sign here:

ContactName

Drop file here! Or click to select!
File Name File Size File Type

Thank you very much you've successfully registered your office for allergy testing. Should you have any immediate questions, please contact your representative: Rene Schena / (408) 821-4884, within a day or so, you will receive login credentials by email AND SMS with instructions on accessing your Patient Data Solutions portal. Following that, within a few days you will receive testing kits. Each kit contains a blood capture card, lancet and alcohol wipe. We will contact you to schedule an orientation call around the time you receive your kits. Once you have portal access, you will use it to:


  • Access patient reports
  • Print test requisitions
  • Print shipping labels
  • Order additional kits
  • Order Immunotherapy if you've requested that functionality

If you have IT related questions in the meantime please email support@patientdatasolutions.com and yes, there are real people that do respond quickly to questions from that email address
We look forward to being of service to ensure your experience with introducing this test into your practice is beneficial and smooth.

Warmest regards,
Rene Schena