Health Portal Deactivation Form

To deactivate a provider for any of our Health Portal services and/or Provider Complete, please complete the following Health Portal Deactivation Form.

*Please keep the following in mind when completing this form:

  • If you choose to deactivate E-Prescribing, this will also deactivate Direct Messaging and PatientPortal.
  • Patient Portal: This deactivation will be for an individual provider(s). If you wish to deactivate PatientPortal for the entire practice, please fill out a separate deactivation request here.
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