Common Contracts

1 similar Provider Site Enrollment Agreement contracts

Instructions for Enrolling in CHIRP
Provider Site Enrollment Agreement • May 5th, 2006

Thank you for your interest in enrolling with the Children and Hoosiers Immunization Registry Program (CHIRP). Before filling out the enclosed paperwork for enrollment in CHIRP please view the enclosed CD for View-Only Training. This video is approximately 8 minutes long and will instruct you on how to use CHIRP. After viewing the video please fill out the enclosed paperwork. Additional information is enclosed about the Registry and our Confidentiality policy.

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