Healthcare Capacity System View Access Requests

Healthcare Capacity System View Access Requests

Please fill out the following information to receive View access to the Healthcare Capacity System. You will receive official account information within 24-48 hours of submission. If you require additional assistance, please submit a ticket to the HCS Help Desk.

Email*

First Name*

Last Name*

State*

Select

User Group*

*If Hospital/Health System, please reach out to your Hospital Primary Contact. If you are unsure who this person might be, please submit a ticket here

EMS/911

County

Oregon Health Authority (OHA)

Other

User Group*

*If Hospital/Health System, please reach out to your Hospital Primary Contact. If you are unsure who this person might be, please submit a ticket here

City/County/State Agency

EMS/911/Fire/Police

Emergency Preparedness

Other

If Other, Please Specify:

Employer/Organization Name:*

Job Title*

Phone Number*

Phone

Extension

Terms of Use

While the Healthcare Capacity System (HCS) does not contain patient or personal identifiable information (PII) or Protected Health Information (PHI), the sharing of information with entities outside of the State/Hospital/EMS/First Responder Community is strictly prohibited. By accessing the HCS, you agree to not share any info beyond these groups (mentioned above) and to the following Terms of Use:

Please take a moment to review the Terms below which apply to your access and use of the Hospital Capacity System. By accessing the HCS, you accept these terms and conditions without limitation:

1) Without limiting any of the foregoing, the content of the Site is provided "AS IS" AND WITHOUT WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING THE IMPLIED WARRANTIES OF MERCHANTABILITY and FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT.

2) You agree that you will hold harmless and indemnify Apprise Health Insights and their agencies and officers from and against any damages based on your use of content of this Site.

Confirmation: Abide by Terms of HCS*

Yes

Send me a copy of my responses

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