OneHealthPort

This form should be completed by the iEXCHANGE® administrator for your organization. This form is a confirmation of the following:

Please complete this online form to Confirm your organization account to access the Qualis Health iEXCHANGE® service.

All required fields are marked with an *

FIRST NAME*

LAST NAME*

Your OneHealthPort UserID*

ORGANIZATION NAME*

iEXCHANGE ID*

email address*

Program participation*

Once you "submit" this form information, you will see a confirmation that you data has been submitted. Qualis Health will do the following:

Send an email confirming your account is still active and ready for use with your OneHealthPort logins.
If you have not already mapped your practitioner NPI numbers, please use the NPI Linking Form request to report your NPI numbers to Qualis Health.
If your account is not active or there are any questions, Qualis will contact you via the email address provided in this form.
Offer training options for any new iEXCHANGE® users in your organization.