This page will help guide you through CliniSync’s enrollment process.
Once you decide to move forward with Contribute, please follow the steps below:
1. Download and complete the CliniSync Physician Participation Agreement. If your practice already has a contract with CliniSync, simply fill out the CliniSync Participant Agreement (Physician) Addendum listed below. There also is a video link that shows you how to navigate the Participant Agreement.
2. Download the CCD/CCDA Document Project Request Form. Work with your current electronic health record (EHR) vendor to complete the form. Your vendor will select and/or define their capabilities.
3. Submit these documents to: firstname.lastname@example.org. A CliniSync representative will follow up with the identified practice contact in three business days.
4. Update your Notice of Privacy Practices (NPP). Click on the links below watch the required video and review the sample text to learn more about this process. Once you have updated your NPP to disclose your partnership with the Health Information Exchange (HIE) and communicate how a patient may opt out, please send the revised version to email@example.com for approval. A CliniSync representative will follow up with the identified practice contact in three business days.
We look forward to working with you!
Should you want to learn more about CliniSync, click on the information links at the top of this page. If you have any questions or wish to talk with a CliniSync representative, please submit a question to firstname.lastname@example.org or call 614-664-2600.