Instructions

Please register for the Provider Portal Jiva 6.3 Training if you plan to attend either an Inpatient or Outpatient session or both. You will have until one day prior to the training date to register.

If you have any questions or concerns, please contact your Account Executive.

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* 1. First Name

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* 2. Last Name

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* 3. Organization

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* 4. E-mail Address

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* 5. Phone Number

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* 6. Inpatient Training Dates and Times (select only one)

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* 7. Will others from your organization also be attending this same Inpatient session?

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* 8. If you answered "Yes, I will provide their full names and contact information on this registration", please enter that information here. Otherwise, please enter N/A in both fields.

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* 9. Outpatient Training Dates and Times (select only one)

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* 10. Will others from your organization also be attending this same Outpatient session?

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* 11. If you answered "Yes, I will provide their full names and contact information on this registration", please enter that information here. Otherwise, please enter N/A in both fields.

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* 12. This is the Zoom information you will use for each session. An invitation will be sent. However, we ask that you also place the following information on your calendar for the session(s) you will attend.

Please click the checkbox to indicate that you have made record of this information.

Zoom link: https://amerihealthcaritas.zoom.us/j/8969186821?pwd=RnZxeVpieHZ1MnhYVngyT2E2bjRSdz09 

Meeting ID: 896 918 6821
Passcode: 329710
Phone: 1-346-248-7799

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