iEXCHANGE® Web Password Reset Form

This form should be completed by the assigned office administrator. Providers should complete this form only if the office administrator is unavailable

*All Fields Are Required
* Provider / Office / Group Name::  
* Tax ID Number:  
* NPI Number:  
* Assigned Administrator’s First and Last Name:
* Contact Phone Number:  
*Assigned Administrator’s Email Address:  
* Numeric iEXCHANGE ID:

Note: The iEXCHANGE Help Desk will email the assigned Administrator the User ID, iEXCHANGE ID and temporary password. Please allow five business days for processing.

 

Updated April 2018