Picture Archiving And Communication System
To request access to the Synapse PACS system, please utilize a provider in your practice to complete and submit this form
Division
Name
*
Credentials
*
(enter NA if not applicable)
NPI
*
Email
*
Facility Name
*
Facility Address
*
City
*
State
*
Zip
*
Facility Phone
*
Facility Fax
*
Approved Name
Approver Email
Access