New Staff HMIS User Account Request Form Add a new staff member to an existing HMIS User Account. "*" indicates required fields Agency Name*Default Program (This should be the program the user will use most frequently)Full Name* First Last Work Email Address* Work Phone*Have you completed the HMIS self paced training?* Yes No Have you submitted the HMIS user agreement form?* Yes No Should you have any additional enter data as? If so, please list the programs below.*CAPTCHA
