Get Okscreen

Filling out the Okscreen form online is a straightforward process that facilitates effective communication with the Oklahoma State Department of Health. This guide provides step-by-step instructions to help users accurately complete the necessary sections of the form.

Follow the steps to fill out the Okscreen form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the facility or company name in the designated space provided.
3. Attach a list of all related entities that this account shall authorize, ensuring it is clear and organized.
4. Fill in the first name, middle initial, and last name of the account applicant, making sure to review for accuracy.
5. Provide the complete address of the applicant in the appropriate field.
6. Enter the proposed user name and phone number to facilitate communication.
7. Include the email address of the applicant for further correspondence.
8. In the user privileges section, check all applicable boxes to indicate the responsibilities of the user.
9. Review the Provider End User Security Agreement and confirm an understanding of the terms.
10. Sign and date the form in the designated areas, ensuring that the signature belongs to the account applicant.
11. An authorized officer of the licensed operating entity must also sign, print their name, title, and date in the provided fields.
12. Once completed, fax or email the finished form to the specified numbers or address.

Start completing the Okscreen form online today to ensure a smooth submission process.