This form allows you to request account reactivation, add a role, update profession and practice number, and configure electronic receipt of results (laboratory match).

To request the addition of an institution to an existing account, please complete this form: Account modification request - Add an institution

To remove an institution to an existing account, please complete this form: Account closing request - Remove an institution

To request the creation of a scanning service, please complete this form: Scanning account creation request

Important notice: The user who is the subject of the request will receive their account information directly via email. No acknowledgement or confirmation email will be sent to the requester. Please allow up to 3 business days for the account to be adjusted.

Account adjustement request

Requester's informations

Your first name*

Your last name*

Your Omnimed ID*

Your email*

User's informations

User's first name*

First name of the user to modify.

User's last name*

Last name of the user of the account to modify.

Omnimed ID of the user*

The Omnimed ID is composed of letters and numbers or numbers (ex. ABCDEF1234 or 1234567).

User's email address*

** WARNING DO NOT ENTER YOUR EMAIL IN THIS FIELD ** In order to adjust the information in our client service tools

Workplace to which the request relates*

For a family practice group (FMG) with many sites, please enter the specific institution where the caregiver works.

Institution paying for the user's license*

Even if the license is free, it must be linked to an institution for the billing process. All accounts must appear on the invoice (even if it is 0$).

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