EIS Access/Removal Request and Staff Update Form
If you are a provider of services for children and youth affiliated with the Office of Child and Family Services, you should complete this form for:
- Complete this form to request :
- Become a new CBHS provider
- Staff access to EIS
- Removal of access to EIS due to staff resignation or change in data entry responsibilities
- Password reset
- Changes in staff names, agency of employment, office location, phone number, or email.