User Request Forms

In order to gain access to the Virtual Gateway, an organization's Access Administrator must complete the appropriate User Request Form (URF) and Rider Form, if required by business service.

User Request Forms (URFs)

Each URF is specific to the Virtual Gateway service an organization will use so please select the appropriate URF below. Please download a copy to your desktop, complete the form as per the instructions on the form, and email the complete form to the email address indicated on the form.

• Agency EIM/ESM User Request Form (***STATE EMPLOYEES ONLY***)
• Agency-based Electronic Visit Verification (EVV) System and Data Aggregator User Request Form (URF)
• Appeals Processing System (APS) User Request Form
• BSAS eLicensing Provider User Request Form
• Children's Behavioral Health Initiative (CBHI) User Request Form
• ClearPoint Strategy User Request Form (State Employees Only)
• Cognos User Request Form (State Employee)
• Community Living Initiative (CLI) User Request Form
• Department of Mental Health Provider Portal (DMHPP) Form
• DCF Management Report Form
• DDS Background Check System User Request Form (Department of Developmental Services Programs Only)
• DYS Agency User Request (URF)
• DYS Provider User Request Form
• Provider EIM/ESM User Request Form
• EOHHS Partners Training Registration System (EPTRS) User Request Form
• Eos (WIC) User Request Form
• File Transfer Service HIPAA User Request Form
• HCSIS User Request Form - Providers
• i-FamilyNet User Request Form
• MassHealth Electronic Notice of Birth (MeNoB) User Request Form
• MDS User Request Form
• Money Follows the Person (MFP) User Request Form
• My Account Page (MAP) User Request Form
• School Nutrition Program (SNP) User Request Form
• SendPro Cognos User Request Form
• SendPro User Request Form
• Turning 22 User Request Form

Job Aids