New HIE (QHN) or CRN User Request

A few practices/organizations are experiencing technical difficulties with this form. Please call QHN’s Customer Support at 970-248-0033 if you cannot get the form to submit or if you do not receive a submission confirmation.

Access to the QHN system must be requested by the “Designated Organizational Contact” for the organization. If you do not know who the Authorized Contact is at your organization, please feel free to contact QHN’s Customer Support at: 970-248-0033.

There is one required form for each New QHN User. The QHN User Application will be sent to the Designated Organizational Contact and the New User. The form is sent via email utilizing the electronic signature service DocuSign. View Request a New QHN User Tip Sheet.

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