PartnerNet Account Request

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PartnerNet Account Request

Fill out the information below. Fields marked with an asterisk (*) are mandatory. Your privacy is assured - see the BCCDC Privacy Policy for more information.

	*Surname:
	Middle Name:
	*Given Name:
	*Health Authority:
	*Organization:
	Department:
	*Job Title:
	*Address:
	*City:
	*Province:
	*Postal Code:
	*Phone Number:
	Phone Number Extension:
	Fax Number:
	*Email:
	Email Notices:	I would like to receive email notices when there are significant changes to the site.
	*Password (at least six characters):
	*Password Confirmation:

Enter a Question with a short one-word Answer that is easy for you to remember (Example: What is your favourite colour?). If you ever forget your password, click Lost your Password? on the Login screen. We will show you the Question and ask to enter the Answer.

	*Password Reminder Question:
	*Password Reminder Answer:

From the list below – please determine and click on which access group(s) best describe your role or duties within your organization, so we can customize your view to include all the related information from PartnerNet.

	*Please click on all access groups that apply:	Content Manager (A BCCDC staff member designated with responsibility for developing or maintaining website content and/or with responsibility for administering access to one or more categories within PartnerNet.) Medical Health Officer (A medical health officer is appointed under the Health Act and is authorized to act within the limits of the jurisdiction of any local board, or within any health district.) Public Health Nurse or Physician (A nurse or physician employed by a health services or social services agency to perform public health services. ) Sexually Transmitted Disease Public Health Nurse (A nurse employed by a health services or social services agency to perform public health services with a focus on sexually transmitted diseases.) PHIS (A person associated with the Public Health Information System (PHIS) as either a committee member, project team member, or other capacity as approved by the PartnerNet administrator for this category.) RO STD Reports (Those people given access to STD Restricted Reports with MHO approval. ) BCCDC Staff (A person that is employed by the BC Centre for Disease Control.) Chief Environmental Health Officer - CEHO (Chief Environmental Health Officer ) Epidemiology Clinic Group (A person that is directly related to decisions made within the Epidmiology Division at the BCCDC.) Communicable Disease Environmental Health Officer (Communicable Disease Environmental Health Officer) Public Health Nurse Administrator (A public health nursing administrator/manager/supervisor in a given Health Authority.)

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