Get Web Plus User Account Request Form

Filling out the Web Plus User Account Request Form is essential for obtaining access to the web-based application managed by the Oklahoma State Department of Health. This guide will provide you with clear, step-by-step instructions to ensure you complete the form correctly and efficiently.

Follow the steps to complete the Web Plus User Account Request Form.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by filling in your abstractor name, facility name, address, city, state, phone number, and zip code. Ensure that all information is printed legibly.
3. Indicate your user function by selecting the appropriate options for online abstraction and file upload by marking the corresponding checkboxes.
4. Provide your email address where your UserID and password will be sent once the form has been processed.
5. For the facility type, circle the option that best describes your facility, such as hospital, ASC, physician, treatment center, pathology lab, or other.
6. In the authorization section, make sure to carefully read the details regarding user access and responsibilities, ensuring that you understand the confidentiality and security measures in place.
7. Sign and date the form in the designated areas. This certifies that you are an authorized registrar or abstractor for the facility listed.
8. Once all sections are completed, review the form for any omissions or errors. Make necessary corrections.
9. Finally, save your changes, then proceed to download, print, or share the completed form as required. Ensure it is sent to the Oklahoma Central Cancer Registry at the address or fax number provided.

Get started on completing your Web Plus User Account Request Form online today!