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 – https://sticomputer.com/enrollments/surescripts-deactivation/

Fields marked with an asterisk (*) are required.