Get Court User Registration / Re-authentication Form - State Of Indiana - In

Filling out the Court User Registration / Re-authentication Form is essential for users seeking access to the Indiana Prescription Monitoring Program (INSPECT). This guide provides detailed, step-by-step instructions to ensure a smooth online completion of the form, addressing each required section and field.

Follow the steps to complete the form easily:

1. Press the ‘Get Form’ button to access the Court User Registration / Re-authentication Form and open it in your preferred editing software.
2. Begin by indicating whether you are a new user or updating your information by selecting the appropriate checkbox.
3. Fill in your requestor name in the designated field; please ensure that you print legibly.
4. Enter the department, program, or court you are associated with in the next field.
5. Provide your job title clearly in the corresponding field.
6. If required, obtain your supervisor's signature in the designated area. This is mandatory if you are not a chief probation officer, court A/D program director, or problem-solving court coordinator.
7. Select your occupation from the provided options by marking the relevant checkbox.
8. Complete the address section by filling out your department/program/court address, including city, state, and zip code.
9. Enter your cell number and telephone number, including area codes, in the specified fields.
10. If applicable, provide your fax number as well.
11. Input a secure personal email address in the required email section to ensure proper communication.
12. Fill in your residence address with city, state, and zip code as instructed.
13. Read the confidentiality statement and sign as the affiant to indicate your agreement and understanding.
14. Write the date of signature and complete the affidavit section as indicated, including your county and state.
15. After completion, you can save your changes, download the form, or print it for submission.

Take a moment to complete your Court User Registration / Re-authentication Form online today.