Medpoint Management

HCLA Health Centers: Click here to login to the new Web Portal 2.0

    Provider Portal User Request Form
  Request User Account
     
  Vendor TaxID:
* If this account requires access to multiple TaxIDs please list them all in the "Note" field below. Provide TaxID, NPI, and Name for each entity.
  Vendor Name:
  First Name:
  Last Name:
  Email:
  Phone:
     
  Login Name:
* You will be assigned a temporary password once we've reviewed your request
  
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  Note:
     
  Requested Provider Access:
Provider Search Panel
  Group:
  Provider NPI or Name:   
 
  Review your User Request
     
  Vendor TaxID:
  Vendor Name:
  First Name:
  Last Name:
  Email:
  Phone:
     
  Login Name:
* You will be assigned a temporary password once we've reviewed your request
  
  Note:
  
  Requested Provider Access:
TERMS and CONDITIONS

By Completing this request you acknowledge you are requesting electronic access to the MedPOINT Management Provider Portal.

You understand that your access, and any staff member's access, is a privileged right and you and your staff further understand the legal responsibilities you have to protect the privacy of our patients from unauthorized use of protected health information. You agree to protect your usernames and passwords and will not disclose them to anyone.