- This page, Enroll in VIP as a medical certifier, is offered by
- Registry of Vital Records and Statistics
Enroll in VIP as a medical certifier
Contact for Enroll in VIP as a medical certifier
Registry of Vital Records and Statistics - V.I.P. Project Team
The Details of Enroll in VIP as a medical certifier
What you need for Enroll in VIP as a medical certifier
The certifier must:
- Go to Register a New Virtual Gateway Organization and complete the form
- Fill out a User Request Form and Email it to VIP-Accounts@state.ma.us
- Sign a VIP User Confidentiality Form and Email it to VIP-Accounts@state.ma.us
How to enroll Enroll in VIP as a medical certifier
The forms required to enroll and important facts about them:
- Register a New Virtual Gateway Organization - @ https://hhsvgapps03.hhs.state.ma.us/OMS/RegisterOrganization Use your address as submitted to the Board of Registration in Medicine or the address of the primary hospital or medical facility at which you are currently working. Do not use your home address. Use your medical license number in place of Tax ID #. The medical license number will need to be expanded to 9 digits with no letters included. Just add zeros to the beginning of your license number. E.g. 123654 becomes 000123654
- VIP User Confidentiality Form (UA) Each user is required to sign this form and it should be emailed along with the User Request Form to VIP-Accounts@state.ma.us
- VIP User Request Form (URF) This document should be filled out electronically and submitted to VIP-Accounts@state.ma.us by email as an attachment in Microsoft excel format only. We cannot accept this form submitted in any other manner and it must be submitted by an Access Administrator
If you have any questions, please contact the VIP project team via email: VIP-Accounts@state.ma.us
More info for Enroll in VIP as a medical certifier
Just a reminder: the information collected through the VIP system is highly sensitive; therefore, it is imperative for the appropriate users to sign the legal agreements in order to gain access to the VIP system. User accounts will be created for each username provided to access the VIP system, after the Virtual Gateway has processed the enrollment application. User account processing takes up to 10 business days.
A brief purpose of each agreement follows:
- Register a New Virtual Gateway Organization online form located at https://hhsvgapps03.hhs.state.ma.us/OMS/RegisterOrganization defines the terms that apply to the organization’s access to the Virtual Gateway services. The signatory level authority at your organization should read and sign the Services Agreement. In the case of medical certifiers, the certifier should be the signatory and use his/her own name and title as the name of the Organization/Entity.
The online form also identifies the access administrator as well as the backup access administrator(s). The terms and conditions listed on the online form describes the responsibilities of the access administrator role such as submitting requests for user account creation, submitting requests for user deactivation, and reporting suspected fraud of the VIP system. The medical certifier should be listed as an Access Administrator. The certifier can also appoint anyone else they want as a secondary administrator.
- The VIP User Confidentiality Form (UA) describes the terms and conditions for use of the VIP system. Each user will identify their functional role and agree to the terms and conditions stated on this agreement. Everyone associated with the VIP system will be required to read and sign the agreement including the access administrators.
- The user request form will need to be completed electronically by the access administrator with the details of each user of the VIP system in your organization and this form should be provided via email. This information is required to generate the VIP and VG user accounts. This form will be used in the future when submitting a new request for a VIP user account.