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Cloud User Request (Add and/or Disable Users)
Cloud User Request
I would like to:
*
Add a user
Disable a user
Reset a Password for a User
What type of user would you like to add? (Choose one only.)
*
Provider
Second Provider Account
Biller
Standard User
What type of user would you like to disable? (Choose one only.)
*
Provider
Second Provider Account
Biller
Standard User
What type of user would you like to add and disable? (Choose one only.)
*
Provider
Second Provider Account
Biller
Standard User
Office / Practice Name
*
Client ID / Account Number (can be found on Invoice):
*
Contact Name
*
First
Last
Contact Phone
*
Contact Email
*
Cloud Username (to reset password)
Cloud Username - (If you are disabling a User):
Cloud Username - (If you are disabling a User):
Cloud Username - (If you are disabling a User):
Cloud Username - (If you are disabling a User):
Cloud Username - (If you are disabling a User):
Cloud Username - (If you are disabling a User):
Cloud Username 1 - (If you are disabling a User):
Cloud Username 1 - (If you are disabling a User):
Cloud Username 2 - (If you are disabling a User):
Cloud Username 2 - (If you are disabling a User):
Cloud Username 3 - (If you are disabling a User):
Cloud Username 3 - (If you are disabling a User):
Cloud Username 4 - (If you are disabling a User):
Cloud Username 4 - (If you are disabling a User):
Cloud Username 5 - (If you are disabling a User):
Cloud Username 5 - (If you are disabling a User):
Do you have additional users to disable?
*
Yes
No
Do you have additional users to disable?
*
Yes
No
Cloud Username 6 - (If you are disabling a User):
Cloud Username 7 - (If you are disabling a User):
Cloud Username 8 - (If you are disabling a User):
Cloud Username 9 - (If you are disabling a User):
Cloud Username 10 - (If you are disabling a User):
Do you have additional users to disable?
*
Yes
No
Cloud Username 11 - (If you are disabling a User):
Cloud Username 12 - (If you are disabling a User):
Cloud Username 13 - (If you are disabling a User):
Cloud Username 14 - (If you are disabling a User):
Cloud Username 15 - (If you are disabling a User):
Please proceed below:
You must fill in both
FIRST
and
LAST
name and a unique
EMAIL
address if you are ADDING a new user.
Each user must have a unique email address
.
Add User
*
First
Last
Email
*
Add User
*
First
Last
Email
*
Add User
*
First
Last
Email
*
Add User
*
First
Last
Email
*
Add User
*
First
Last
Email
*
Add User
*
First
Last
Email
*
Add User 1
*
First
Last
Email for User 1
*
Add User 1
*
First
Last
Email for User 1
*
Add User 2
First
Last
Email for User 2
Add User 2
First
Last
Email for User 2
Add User 3
First
Last
Email for User 3
Add User 3
First
Last
Email for User 3
Add User 4
First
Last
Email for User 4
Add User 4
First
Last
Email for User 4
Add User 5
First
Last
Email for User 5
Add User 5
First
Last
Email for User 5
Do you have additional users to add?
*
Yes
No
Do you have additional users to add?
*
Yes
No
Add User 6
First
Last
Email for User 6
Add User 7
First
Last
Email for User 7
Add User 8
First
Last
Email for User 8
Add User 9
First
Last
Email for User 9
Add User 10
First
Last
Email for User 10
Do you have additional users to add?
*
Yes
No
Add User 11
First
Last
Email for User 11
Add User 12
First
Last
Email for User 12
Add User 13
First
Last
Email for User 13
Add User 14
First
Last
Email for User 14
Add User 15
First
Last
Email for User 15
CLOSE
