Please request access via email with subject line:
DHMSO Provider Portal Access Request
Send email to: CI-ACOhelpdesk@dignityhealth.org
Please Note: The Authorized Representative (Office Manager or Delegate chosen by the contracted group) is responsible for submitting all access requests (new, terms and audit reviewer). There should be 2 or 3 Authorized Representatives per contracted group, please reach out to your Provider Relations Rep for this designation.
To Receive Email with Template Form, please add Email Address and press 'Receive Template'
Input value is an invalid email address.
Please select a Registration Template: