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Enrollments

PatientPortal Deactivation Form

To deactivate your PRACTICE from PatientPortal, please complete the following PatientPortal Deactivation Form. IMPORTANT: If you wish to deactivate an INDIVIDUAL PROVIDER, you will need to fill out our SureScripts Deactivation form here – http://sticomputer.com/enrollments/surescripts-deactivation/

Fields marked with an asterisk (*) are required.


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