Use this form to request access to WTH system applications for an employee or student. Use of this form is governed by the applicable management guidebook policies regarding the access and use of IS/IT systems.

For Non-WTH employees (ie. Non-WTH Clinic, Post Acute Provider, Insurance Companies, Third Party Biller, etc), To request access for these entities, refer to the instructions at https://www.wth.org/external-access-requests/ and complete the appropriate form. Requests using this form will be denied.