Get Access Request Form For Sftp - Hawaii Health Information ...

This guide provides a detailed walkthrough for users completing the Access Request Form For SFTP - Hawaii Health Information online. By following these steps, users can ensure they fill out the form correctly and efficiently.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin filling out the form by entering your organization name, followed by your full name in the format of last name, first name, then your title.
3. Indicate your areas of responsibility by selecting applicable options such as safety/quality, clinical services, marketing/planning, operations, financial services, or any other area relevant to your role.
4. Provide your mailing address, email, phone number, and fax number in the specified fields.
5. Enter the required identifiers for resetting your access, including your home zip code, your mother’s first name, and the last four digits of your social security number.
6. Ensure you fill in HHIC Approval fields with the relevant approval information and signatures where necessary.
7. Review the confidentiality agreement and acknowledge that your sign-on code acts as your legal signature. Make sure you understand the responsibilities associated with access.
8. Once all fields are completed, save your changes, and prepare the document for printing.
9. Print the completed form and the Data Use Agreement for the necessary signatures.
10. Submit the signed forms by faxing them to 808-534-0292 or mailing them to the specified address of Hawaii Health Information Corporation.

Complete your Access Request Form for SFTP online today to ensure seamless access to necessary health information.