Electronic Update Request - Service At Location Profile

If you need help completing a change request, hover over the circle with the question mark and a short description of the field will display.

Please include inclusive language when making changes.

Service Name

Location Name

Confidential

Yes

Descriptive Line/Building Name

Suite

Building Number

Street Name

Street Type

Quadrant

City

Province

Postal Code


Toll Free: 1-866-624-2785
Fax: 780-624-2046
Website: https://www.ahs.ca/renalservices

Is 24 Hour?

Yes

	12:00 AM 12:15 AM 12:30 AM 12:45 AM 1:00 AM 1:15 AM 1:30 AM 1:45 AM 2:00 AM 2:15 AM 2:30 AM 2:45 AM 3:00 AM 3:15 AM 3:30 AM 3:45 AM 4:00 AM 4:15 AM 4:30 AM 4:45 AM 5:00 AM 5:15 AM 5:30 AM 5:45 AM 6:00 AM 6:15 AM 6:30 AM 6:45 AM 7:00 AM 7:15 AM 7:30 AM 7:45 AM 8:00 AM 8:15 AM 8:30 AM 8:45 AM 9:00 AM 9:15 AM 9:30 AM 9:45 AM 10:00 AM 10:15 AM 10:30 AM 10:45 AM 11:00 AM 11:15 AM 11:30 AM 11:45 AM 12:00 PM 12:15 PM 12:30 PM 12:45 PM 1:00 PM 1:15 PM 1:30 PM 1:45 PM 2:00 PM 2:15 PM 2:30 PM 2:45 PM 3:00 PM 3:15 PM 3:30 PM 3:45 PM 4:00 PM 4:15 PM 4:30 PM 4:45 PM 5:00 PM 5:15 PM 5:30 PM 5:45 PM 6:00 PM 6:15 PM 6:30 PM 6:45 PM 7:00 PM 7:15 PM 7:30 PM 7:45 PM 8:00 PM 8:15 PM 8:30 PM 8:45 PM 9:00 PM 9:15 PM 9:30 PM 9:45 PM 10:00 PM 10:15 PM 10:30 PM 10:45 PM 11:00 PM 11:15 PM 11:30 PM 11:45 PM	12:00 PM 12:15 PM 12:30 PM 12:45 PM 1:00 PM 1:15 PM 1:30 PM 1:45 PM 2:00 PM 2:15 PM 2:30 PM 2:45 PM 3:00 PM 3:15 PM 3:30 PM 3:45 PM 4:00 PM 4:15 PM 4:30 PM 4:45 PM 5:00 PM 5:15 PM 5:30 PM 5:45 PM 6:00 PM 6:15 PM 6:30 PM 6:45 PM 7:00 PM 7:15 PM 7:30 PM 7:45 PM 8:00 PM 8:15 PM 8:30 PM 8:45 PM 9:00 PM 9:15 PM 9:30 PM 9:45 PM 10:00 PM 10:15 PM 10:30 PM 10:45 PM 11:00 PM 11:15 PM 11:30 PM 11:45 PM 12:00 AM 12:15 AM 12:30 AM 12:45 AM 1:00 AM 1:15 AM 1:30 AM 1:45 AM 2:00 AM 2:15 AM 2:30 AM 2:45 AM 3:00 AM 3:15 AM 3:30 AM 3:45 AM 4:00 AM 4:15 AM 4:30 AM 4:45 AM 5:00 AM 5:15 AM 5:30 AM 5:45 AM 6:00 AM 6:15 AM 6:30 AM 6:45 AM 7:00 AM 7:15 AM 7:30 AM 7:45 AM 8:00 AM 8:15 AM 8:30 AM 8:45 AM 9:00 AM 9:15 AM 9:30 AM 9:45 AM 10:00 AM 10:15 AM 10:30 AM 10:45 AM 11:00 AM 11:15 AM 11:30 AM 11:45 AM
Monday 6:45 AM - 7:00 PM
Tuesday 6:45 AM - 7:00 PM
Wednesday 6:45 AM - 7:00 PM
Thursday 6:45 AM - 7:00 PM
Friday 6:45 AM - 7:00 PM
Saturday 6:45 AM - 7:00 PM

Hours of Operation Note

Waiting Period Same As Service:

Yes

Waiting Period

Waiting Time

Waiting Unit

Waiting Period Note

Same As Service:

Yes

Languages

Languages Note

Wheelchair Accessible

Wheelchair Accessible Note

Other Disabled Access

Other Disabled Access Note

Transportation Description


Connect Care System Department Name: PRH PRCH HD
Connect Care Department ID: 101062158

Contact Name *

Please enter contact name.

Title

Telephone *

Please provide a phone number or email.

Email *

Please provide a valid email.

Comments

If No Changes Required to the record, select the checkbox and fill out the "Verification Contact Information" above. An email will be sent to confirm submission.

If this submission is successful, and you have provided your email address, you will receive an email confirmation.
If you do not receive this, please contact healthlink@primarycarealberta.ca