Health Portal Enrollment Form (Provider)

The form below will allow you to register for one or more of the following servces:

  • Electronic Prescribing (e-RX)
  • Direct Messaging (DM)
  • Electronic Prescribing of Controlled Substances (EPCS)
  • Electronic Prior Authorization (ePA)
  • PatientPortal
  • Provider Complete

NOTE: Once you have submitted your enrollment, please be sure to check your email inbox for a confirmation with further instructions.

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