As an Independent Practice, access to Epic is typically all that is needed. If additional access is needed, such as badge access, a non-employee packet for patient information only will need to be complete and the CHI Sponsor will need to complete the Non-Employee intake form. Please note: For Legacy Alegent Locations only, CHI Sponsor should utilizing job code: Lease/Parking Access Only on Intake Form and not Independent Practice.
Complete all sections and e-mail the signed and completed form to: firstname.lastname@example.org.
Access generally will be processed within 7–10 business days.