Dignity Health Management Services (DHSMO) has installed various Information Technology resources allowing computerization of information.  The utilization of these automated systems will communicate information to authorized users more efficiently and effectively, leading to quality improvement in patient care and business services.  In order to protect the information contained in the DHSMO databases and to prevent unauthorized use of all information, access to these Information Technology resources will be limited to those persons who are issued an access code by DHSMO.

Provider Portal Account Reinstatement Form

Account Information

* indicates a required field

* User Name:


* Last Name:


* First Name:

Middle Initial:

* Job Title:


* Company:






* Email:


* Confirm Email:


Reason For Reinstatement: