EIS Access/Removal Request and Staff Update Form
If you are a provider of mental health services for adults affiliated with the Office of Substance Abuse and Mental Services, you should complete this form for:
- Complete this form to request :
- 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.