You must have access to the Internet and have an email address to enroll as a provider and access Home Health data.

1. Begin by downloading and printing the Enrollment Package

• New Electronic Home Health Physician Form — Attachment C
• ITS Consent Form — Attachment D
• Signature Approval Form (HPF signature stamp electronic)— Attachment E
• Mail/Fax Cover Sheet — Attachment F & G
• Signature Approval Form - (HPF signature stamp electronic)
• Mail/Fax Cover Sheet — Attachment F & G
  
  Download the package.

2. Read, Complete & Sign the Enrollment Documents
3. Mail or Fax Completed Information to John Muir Home Health Services (cover sheets are included in the package.)

What You Can Expect

• Upon review of the enrollment information, the enrollment specialist will contact you if there is any missing documentation. When your status changes to approved, you will receive an email acknowledgement card.
• Within 30 business days you will receive an email from extranetsupport@johnmuirhealth.com with remote access account and login information.
• You may complete the education modules on-line at anytime.