EHO360 SFTP Account Request Form

EHO SFTP Account Request Form

Version 2
Complete this form to request an EHO SFTP account for uploading and retrieving files.

PLEASE NOTE:
- EHO requires IP addresses to access its systems. Be sure to provide them in the section indicated.
- This form needs to be completed in a single session. If you exit the form or your session times out, progress will be lost.
For assistsance, contact us by email at helpdesk@ehorx.com attention Bob or Trent.

Company Name*
Reference Number*
Enter the reference number provided by your account manager.
Entity Type*
Indicate the type of business entity your company falls under.
Other selected. Indicate entity type in the space provided.*
Example: TPA
Requester*

First NameLast Name
Requester Email*

Confirmation Emailexample@example.com
Requester Phone Number*
Please enter a valid phone number.
Provide a phone extension if needed:
Example: ext 123
Can the person listed above be contacted with technology-related questions?*

Yes, the requester can be contacted with technology-related questions.No, another employee will need to be contacted with technology-related questions.
Technology Contact*

First NameLast Name
Technology Contact Email*

Confirmation Emailexample@example.com
Technology Contact Phone Number*
Please enter a valid phone number.
Provide a phone extension if needed:
Example: ext 123
Please tell us more about your request:*

I need a new setup.I need to submit changes for an existing setup.I have an existing setup and would an additional setup added.
Enter changes below.*
Who will be providing the secure FTP server?*

My company will provide the secure FTP server.My company needs EHO to provide the secure FTP server.
Note: SFTP may be inaccessible from home computers due to network restrictions. If your company uses dynamic IPs, they’ll need to provide the SFTP server.
When do you want to start sending and receiving files?

MonthDayYear
Enter a date in the field provided.
Enter your EHO Client Services username. A secure message with a link to set up your credentials will be sent to your registered email.*
EHO Client Services Username

Your company will provide the secure FTP server. Please complete the sections that follow.

EHO supports using the SFTP protocol.
Host name or IP Address *
Example: sftp.yourcompany.com or 8.8.100.157
TCP Port Number*
Example: 22
Username*
Must be in all lower case, without spaces. Do not use special characters.
Provide the directory for files EHO will pick up from your company in the space below. *
Example: /inbound/patient-20211115.csv
Provide the directory for files EHO will be sending to your company in the space below. *
Example: /outbound/patient-20211115.csv
Describe your company's file naming conventions below. Please include an example for reference.
Examples of common conventions: Use underscores instead of spaces in file names; Include a unique identifier, such as a date in YYYYMMDD format; Use all lower case letters.
If files need to be in a custom format, upload the specifications here.

Cancelof
Do you require files to be encrypted at rest using PGP encryption? If so, please upload your public PGP key file.

Cancelof
Download our public PGP and at it to your keyring from here:

https://www.ehorx.com/html/eho-public-pgp-key.txt

EHO SFTP Server Info and Instructions

Keep a copy of this information for reference.
EHO SFTP Server address: sftp.ehorx.com

Incoming and outgoing file locations:
- Put files uploaded to EHO in the /incoming directory.
- Files created by EHO for you to pick up will be put in the /outgoing directory.
Companies providing their own SFTP server: Keep a copy of the information below for reference.
A Public Key is required to authenticate for delivery to third-party SFTP servers. Use the following URL to access the Public Key:

https://ehorx.com/html/eho-public-sftp-key.txt

Using a firewalled SFTP server?

Be sure to add EHO's server block to your list of allowed IP addresses if needed. EHO's block is: 12.14.58

Any changes to your company's host key will render this service inoperable!

If your company's server host key changes at any point, please notify EHO at helpdesk@ehorx.com as soon as possible.
EHO recommends printing a copy of this page for your records.

Please confirm the following before submitting this request form:*

I hereby certify that I am an authorized representative of the Company for which the SFTP request is being submitted and that the information set forth in this document, and in any attachments, is true and correct to the best of my knowledge.
Enter your name to certify the selection above.*

First NameLast Name
Reminder: Click SUBMIT!
Should be Empty:

EHO SFTP Account Request Form

Your company will provide the secure FTP server. Please complete the sections that follow.

EHO will be providing the secure FTP server. Please complete the sections that follow.

EHO SFTP Server Info and Instructions

Companies providing their own SFTP server: Keep a copy of the information below for reference.

EHO recommends printing a copy of this page for your records.

Reminder: Click SUBMIT!