User Request Forms (URFs)
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.
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.
- Appeals Processing System (APS) User Request Form
- Background Check System User Request Form
- BSAS eLicensing Provider User Request Form
- Children's Behavioral Health Initiative (CBHI) User Request Form
- COGNOS User Request Form
- Department of Mental Health Provider Portal (DMHPP) Form
- DCF Management Report Form
- DYS Agency User Request Form
- DYS Provider User Request Form
- EIM/ESM 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
- MDS User Request Form
- My Account Page (MAP) User Request Form
- School Nutrition Program (SNP) User Request Form
- Turning 22 User Request Form
- Women's Health Network (WHN) User Request Form