Community Electronic Health Integration (EHI) extends PeaceHealth technology for a patient centered approach to care and services with independent providers and community healthcare partners.
Please complete BOTH the Information Systems User Setup Request Form and Confidentiality Agreement.
Please type your information into the boxes and click Print Form.
NOTE: We require all information to be filled out including SSN and supervisors signature. Please make sure to sign and date page 1 and 3.
Security training is required for all access requests.
NOTE: Please watch the security training video and take the security quiz at the end. Print the certificate of completion and fax in with the user setup request form.
Fax the completed user setup request form and security training certificate to 541.434.3174.
NOTE: Please allow 48 hours for processing before inquiring about status.
Please use this electronic form to request removal of a user from any or all of EHInet services.
Please use this electronic form to request VPN access. You will be contacted within 24-48 hours once your request has been processed.
Use this link to update/change your PeaceHealth network/Citrix/Epic/PH Link password.
EHI Mobile Device Email/Wireless Access Request Form.
This electronic form is only to be used to modify existing active access to Centricity, Imagecast, CareConnect(Epic) or PH Link. It is not to be used to request a new activation or a reactivation of these systems.
Request for a provider to be added to Centricity Enterprise (CE) and Epic Ambulatory (CareConnect). This form is to be used for Providers NOT already in CE or CareConnect.
Questions? Please contact the Peacehealth service desk at 541.222.6464 or 1.800.452.1425