ENITS Modality Request Form

Emergency Neurosurgery Image Transfer System (ENITS) PACS Modality Change Form

Site / Hospital Name(Required)

Primary Site DI / IT Contact

Name(Required)

Email(Required)

Phone(Required)

Alternate Site DI / IT Contact

Name

Email

Phone

Other Site DI / IT Contact

Name

Email

Phone

Modalities

Select Request

Add

Modify

Remove

Modality Type

Modality Make and Model(Required)

AE Title(Required)

Internal IP for the Modality

Port(Required)

NAT'D IP

A NAT’D IP should be available from your network team.

Add ModalityRemove Modality

OCINet ENITS DICOM Information

ENITS programming details:

AE Title: EAENITS
Port: 104
Server IP: 138.218.233.250