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Deaconess CareLink

To obtain access to Deaconess CareLink (EpicCare® Link Epic Systems Corporation) from your office as well as other remote locations for new office employees or to report employees no longer working for your office, please complete this form. For more information or questions, please call 812-450-EPIC

This request for access must be completed by the practice manager.

Any account not used within 180 days will be disabled.

* indicates a required field.

Once you have filled in the required fields, click on the "Submit" button at the bottom of the form. When the accounts have been created, Deaconess Business Development Group will email or call the practice manager to provide the new user IDs/passwords, schedule training and validate the practice manager submitted the request.


As a condition of access to the network and patient record systems of Deaconess Health System ("Deaconess"), the undersigned agrees on behalf of practice names listed below to the following Terms of Use.

  1. Access to the network and electronic patient record systems of Deaconess is a privilege and not a right of association with Deaconess, and may be terminated at any time and for any reason.
  2. Access to the network and patient record systems of Deaconess is provided to external providers and members of their staff solely for the business needs of the provider and subject to all applicable federal and state laws.
  3. Access to patient records maintained by Deaconess is permitted only for those patients with whom the Practice has a professional relationship as the private, attending, admitting, referring, consulting or on-call provider.
  4. The Practice will identify those individuals within Practice who require access to the Deaconess network or patient record systems in order to perform their essential job functions, and will assure  that all such individuals identified have read and signed the End User Terms of Use Agreement
  5. Each authorized user will be issued a unique user ID and password which may only be used by the person to whom it is assigned.
  6. The Practice will notify the Deaconess Information Systems HelpDesk within 7 days if an individual's change in, or termination of,  job responsibilities requires modification to his/her user privileges.
  7. The Practice will promptly notify the Deaconess Privacy Officer or Information Security Officer of any alleged or known unauthorized use of the Deaconess network or patient record systems by any person.
  8. All persons associated with Practice will cooperate in any investigation conducted by Deaconess involving an alleged or known unauthorized acquisition, use or disclosure of information from Deaconess patient records.
  9. The Practice is responsible for developing its own policies and monitoring program regarding privacy and security of information, for educating its staff on these policies, and for taking corrective action when its policies are violated.
  10. End-user violations of the End User Terms of Use Agreement may result in corrective action by Deaconess up to and including termination of user privileges.
  11. Violations of this Practice Terms of Use Agreement may result in suspension of all user accounts assigned to Practice.
  12. Breaches of the protected health information or personal information of Deaconess patients will be reported in accordance with applicable statutes to the person(s) whose information was breached and, as appropriate, to state or federal authorities.
  13. This Practice Terms of Use Agreement will take effect on the date it is signed by Practice.

By checking the "I agree" box below, I certify that I have read and accept the Terms of Use Agreement and that I am authorized to make this request.
Type of Facility:
(Depending on facility type, a BAA may be required before access can be granted. You will be contacted if one is needed.)

Please complete the request for each staff member needing access to patient clinical data and insurance information and/or each staff member terminating employment with your office who had access to Deaconess computer system. Once the information is completed, click the "Submit" button below.
Front Desk - gives access to patient demographic and insurance information
Biller - gives access to above plus partial patient record
Clinical - gives access to above plus the ability to view the complete patient record
Office Manager - gives access to the above plus ability to reset passwords of staff using CareLink. (Only two per practice)
Pharmacist – same access as Clinical plus the ability to view the medical administration record (registered pharmacists only)
EMT Billing – gives access to the demographic and insurance information for billing by EMT and ambulance services

All fields are required for each person for which access is being requested.
Request 1
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Request 2
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Request 3
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Request 4
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Request 5
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Additional Comments
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