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Connect Care: Centralizing Operational Processes – Updating Forms

July 6, 2021 – AHS Memo

Alberta Health Services (AHS) has implemented a “Request for Provider/Prescriber Set-Up in Health Information Systemsform to allow community providers to advise different groups within AHS and affiliated organizations of new information or changes to:

  • Provider/prescriber name; professional and Connect Care identifiers; practice location(s); locum status
  • Clinic/location/client/office name, demographics (address, contact information), etc.
  • Preferred method for receiving results and other information from AHS and affiliated organizations

The new single form replaces the Alberta Precision Labs Healthcare Provider Information and Set Up forms, the DynaLIFE Healthcare Provider Setup Request Form, and the eDelivery Service Request Form.

What does this mean for clinics and providers?

The new form will support centralized operational processes for the maintenance of provider master data, including identity data and external venues where provider/prescribers deliver care. Please update clinic and provider information with as much notice as possible.

  • Please replace any saved versions of forms with the new one and point all links to the form to A completion guide for users of the form is also available.
  • This smart form can be completed & submitted online, printed and faxed to 1.780.644.1792; or printed, scanned and emailed to
  • eDelivery users:
    • Requests from clinics using eDelivery are still required to include their EMR vendor in the requests process, to provide EMR-specific information with each request. EMR vendors remain able to submit the form on behalf of their clients.

If you have questions about this new process, please contact

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