DHS COVID Tracking - User Change Request
Use this form to request a new user to respond on behalf of your organization in the DHS COVID Tracking Tool. Once submitted, the new user will receive an email notification that their account is active in the tool. This process takes a few business days to complete.
Required fields are denoted with an asterisk (*).
Please enter the following identifying information of the facility/provider that the user will be reporting on behalf of. Either a License Number, Facility ID, or MPI is required.