Get Hspolicy

This guide provides clear, step-by-step instructions on how to effectively complete the Hspolicy online form, specifically designed for the provider interface individual user access request. Whether you are familiar with digital forms or not, this comprehensive resource will support you through each section of the form.

Follow the steps to successfully fill out the Hspolicy online form.

1. Press the ‘Get Form’ button to obtain the form and open it for editing.
2. In the ‘Individual User Name’ section, enter your first name, middle initial, and last name clearly.
3. Provide the name of your provider in the ‘Provider Name’ field.
4. Input your telephone number in the ‘User’s Telephone’ section.
5. Fill in your email address in the ‘User’s Utah ID Email’ section.
6. Enter the provider site address in the designated area, ensuring accuracy.
7. Read the ‘Statement of Understanding’ carefully and make sure you comprehend the security and confidentiality requirements outlined.
8. Initiate your acceptance of the terms by placing your initials and the date in the appropriate fields.
9. Sign the applicant signature section and indicate the current date.
10. A representative from the provider must sign, along with their name printed and the date.
11. Once all fields are completed, either save the changes, download the document, print it, or share it as needed.

Start completing your Hspolicy online form today!