HMIS New User Access Request

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New HMIS User Account Request
Welcome to the SSF HMIS New User Access Request process. Please review the following information carefully to ensure you complete this form correctly:

Who Can Submit This Request?
Requests for new user access must be submitted by supervisors or other agency leadership. This requirement ensures that requests includes the correct access level information and the signed documentation confirming that the user has passed a background check. Staff members may not submit their own HMIS access requests. If it is discovered that staff at your agency are being instructed to request their own access, HMIS may need to revisit your agency's HMIS Participation Status. Thank you for your cooperation in maintaining system security and regulation compliance.

Agencies Applying for HMIS Participation
If you have recently submitted a form to become an HMIS Participating Agency, please do not fill out this form requesting HMIS access for your staff until you receive an email stating that your application has been approved.
New HMIS User's Full Name*

First NameLast Name
New HMIS User's Title*
New HMIS User's Email*
Work Email Address Only
New HMIS User's Phone Number*

Request HMIS User Access
- Full Name of Person Completing this Request*
  
  First NameLast Name
- Title*
- Email*
  Work Email Address Only
- Phone Number
- Please select your role:*
  
  Supervisor (submitting on behalf of the HMIS End User)Executive Director/CEO (submitting for yourself)Other administrative staff (submitting on behalf of the HMIS End User)
- Do you directly supervise the staff member you are requesting HMIS access for?
  
  Yes, I supervisor this staff member.No, I do not supervise this staff member. I will enter the staff member's supervisor's contact information below.
- Supervisor's Name
- Title
- Supervisor's Email
  Work Email Address Only
- Phone Number
- Please select the Continuum of Care (CoC) your organization is associated with:*
  
  Sacramento CoC (CA-503)Yolo CoC (CA-521)
- Primary Agency Access Name - Sacramento*
  Please select the primary HMIS Agency the user will need to access in HMIS.
- What SSF department do you work in?
- Other: please provide details about what SSF department you work in
- Primary Agency Access Name - Yolo*
  Please select the primary HMIS Agency the user will need to access in HMIS.
- Will the user be monitoring contracts for providers you fund?
  
  YesNo

Submit Your Request
NEXT STEPS
Upon receiving this form submission, a few emails will be sent out.

HMIS will send an email to the staff member's supervisor with a request to complete the Staff Verification Form, which includes confirmation of a successful background check. Please complete that form and send it back to HMIS.

HMIS will send out an email to the staff member with instructions for accessing and completing the HMIS training. They have two weeks to complete their training and pass their HMIS training quiz. Once a passing quiz is submitted, HMIS staff will create the new account and email the new HMIS user with their login credentials. The user needs to log into HMIS within 24 hours to create their new password and keep the new account active.

As always, if you have any questions please email HMIS.
You selected "My agency is not on this list." HMIS Access is not provided to individuals. All access is provided through HMIS Participating Agencies.

Our Agency Recently Requested to Become an HMIS Participating Agency
Most of the time, this is the reason why your agency's name is not showing up in this list. this is because your agency is still in the process of being approved to become an HMIS Participating Agency. New user requests can only be processed after the agency request has been approved. Please email HMIS so we can let you know where your agency is in the onboarding process.
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