Forms
The forms below are securely encrypted and the information will be stored on a highly protected server once you have submitted the form. The server is securely protected permitting the BRAINS staff (exclusively) to retrieve the information. This electronic format meets record security regulations similar to filling out the paper format.
Medical professionals submitting prescriptions for services - Please take a moment to set-up your Secure Digital Signature. Located at the bottom of the prescription, there will be a pink box in the signature area. By clicking on this with your mouse-pointer, the application will prompt you to create a password for the Authentication of your Digital Signature and automatically stamp your Digital Signature with the time and date. In the future, you will be promted for your password each time you use this feature and your Digital Signature will be verified automatically. Also, you will be able to print a copy for your personal records.
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