eReferrals LHD access request

If you need to add one staff member, please use this form. Staff can request access themselves (the project team will verify with the clinic manager), or the clinic manager can do this on someone’s behalf.

If you need access for multiple staff members, use this form below.

Request access for single staff members

eReferrals Access Request

Name of staff member to be added
First Last
Email of staff member to be added
Stafflink ID of staff to be added
Clinic
Brief description of issue
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.

Request access for multiple staff members

Download this template, complete, and then use the form below to upload the file, or email directly to the project team lead (Timothy Marsh).

Your name
First Last
Your email
File
Max. file size: 8 MB.
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.