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PASIIS User Account RequestHD1142F REV 02/21This form is to be completed to request a user account in Pa. Statewide Immunization Information System (PASIIS).Requester Information Please Print or Type.

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What is pa-siis user account request?

The pa-siis user account request is a formal application process for establishing a user account within the PA-SIIS (Pennsylvania Statewide Immunization Information System) platform, which is used for managing immunization records.

Who is required to file pa-siis user account request?

Healthcare providers, immunization administrators, and organizations that need to access immunization data for patients are required to file a pa-siis user account request.

How to fill out pa-siis user account request?

To fill out the pa-siis user account request, applicants need to complete a designated form, providing necessary details such as organization information, the type of access needed, and the names and roles of individuals requesting access.

What is the purpose of pa-siis user account request?

The purpose of the pa-siis user account request is to grant access to the PA-SIIS system for managing and retrieving immunization data securely and efficiently.

What information must be reported on pa-siis user account request?

The information that must be reported includes the applicant's name, organization details, email addresses, types of access requested, and staff members who will use the system.

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