User account | IBD Passport

Personal details

(Of person filling this registration. The details are for internal management purpose only and will not appear on the website.)

I am a Healthcare Professional and wish to register my IBD centre with the IBD Passport network.

Registering with the IBD Passport network is free and does not obligate you or your IBD centre to provide medical care. The aim to provide a comprehensive global IBD centre network. Selected details of your centre will appear on the IBD Network page map.

I am a Healthcare Professional and want to register for personal use only.

If you decide at a later date that you want to extend your registration to include your IBD centre (which will then be included on the IBD network map) then you can do this by logging in and clicking ‘Edit profile’ and then follow the steps to provide additional information about your centre.

This field is required.

First Name *

Last Name *

Are you a member of a Professional Gastroenterology medical/nursing Association e.g. American Gastro Assn. British Society of Gastroenterology, European Crohn's & Colitis Organisation, Gastroenterology Society New Zealand? *

Yes

IBD center details

Name of Medical center/hospital *

Full Hospital / Practice Address Line 1 *

Full Hospital / Practice Address Line 2

Full Hospital / Practice Address Line 3

Your Postcode in Country of Residence *

Country of Hospital / Practice * Country of Hospital / Practice

City of Hospital / Practice * City of Hospital / Practice

Address in local language (if different from above)

IBD Passport Centre contact details for travellers

(Please complete these details for the contact person in your centre, who should be contacted by IBD travellers if they want to receive care at your centre)

Name of contact person for IBD passport patients *

Role of contact person (IBD nurse/IBD doctor/else) *

Department Telephone Number *

Department Fax Number

Mobile (for internal purpose only-will not appear on website)

Department Email Address *

Media contact id for contact person (Wechat/Whatsapp)

Languages spoken by contact person (English mandatory)

Languages spoken by personnel or available by translators

List all Healthcare Professionals in your department that you would like to be included in your IBD Centre listing

Name of Director/Lead of Gastroenterology Department *

Name of IBD center Director (if not the same person)

Email of Gastro/IBD director (will not appear on website)

What best describes your Centre/Hospital? *

Tertiary / University hospital

Regional hospital / District general

Medical center or clinic

Facilities*

(tick all that apply)

Facilities *

Emergency room

Hospitalization wards

Operation theaters

Infusion center for biologic drugs

Endoscopic unit

On-site laboratory

Radiology (CT Enterography and/or MR Enterography)

Personnel*

(tick all that apply)

Personnel *

IBD-specific surgeon

IBD nurse

Rheumatologist

Dermatologist

Ophtalmologist

Gynecologist

Infectious disease expert

Number of clinician specialising in IBD? *

IBD nurse

Available infusion/injection medicines*

(tick all that apply)

Available infusion/injection medicines *

IV corticosteroids

Antibiotics

IM/SC methotrexate

Infliximab (Remicade)

Infliximab biosimilar (inflectra/Remsima/Flixabi)

Adalimumab (humira)

Vedolizumab (Entyvio)

Certolizumab (Cimzia)

Other SC/IV IBD-specific drugs available

Photo upload

(Please upload photos of your institution. Only the outside hospital view image is mandatory (to help travellers with orientation in your neighbourhood).)

Picture of medical center (street view – for easy orienteering)

Files must be less than 2 MB.
Allowed file types: png gif jpg jpeg.
Images must be at least 300x300 pixels. Images larger than 1200x1200 pixels will be resized.

Picture of IBD team