Patient Reports

To register your practice for access to Promedicus.net secure report delivery, please complete the online form here.

Alternatively, you may download the form and return it via email to the provided address.

Practice Information

Practice Name *

Practice Address *

Practice Contact *

Practice Telephone Number *

Practice Fax

Practice Email Address *

Are you already using Promedicus.net for downloading results?

*All fields must be completed. Enter “N/A” if not applicable*