Provider Registration

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Registration

A National Provider Identifier (NPI) number is required to verify professional access to ViiV Healthcare support. Healthcare professional accounts must be registered with a valid NPI.

Clinic staff member accounts must be linked to a registered HCP account before clinic staff members can print TAP and HLA-AWARE™ CERTIFICATES on behalf of the HCPs they support.

Please tell us which type of account you would like to create:

Healthcare Professional

Clinic Staff Member

Clinic staff members must add at least one registered healthcare professional (HCP) to the clinic staff account for printing access with the Diagnostic Resource Center. HCPs will be notified of this action and can choose to revoke your privileges at any time. Please be sure that the HCP you selected is aware and aligned with you linking to their account, as he/she will be notified of this action.

Once a registered HCP is added to your clinic account, you can continue registration.

Healthcare Professionals

NPI	First Name	Last Name

Clinic Staff Member Information

*Required Field

*Prefix	*First Name	*Last Name
*Clinic Name
*Mailing Address	Address Line 2
*City	*State	*Zip Code
*Phone XXX-XXX-XXXX	*Fax XXX-XXX-XXXX
*Email The e-mail address you provide will be needed to log back into your account, along with your site.
*Confirm Email
*Password 6+ characters, 1 or more numbers
*Confirm Password

In order for clinic staff members to print and request HLA-AWARE™ CERTIFICATES, the HCP(s) added to your account must be approved for the HLA-AWARE™ Program. For program approval, HCPs can make requests through a ViiV Healthcare representative.

Only five clinic staff members can be linked to an HCP account at a time. Once the 5-member limit is reached, the HCP you’re trying to add must revoke privileges from an existing member before you can add him or her to your clinic staff account.

Please note: HCPs are notified each time a clinic staff member is added to the HCP's account. The HCP will have the ability to revoke staff member privileges at any time.

*I agree to the following terms:

By completing this registration, you are verifying that the HCP(s) you have added to your account are aware you will be printing CERTIFICATES on their behalf, acknowledging that ViiV Healthcare will maintain the information you have provided for the purposes of professional communication, and agreeing that ViiV Healthcare may send you notification of site updates and periodic messages and contact you as needed to update or maintain your registration information. ViiV Healthcare will not sell or share this information with third parties for their marketing purposes and will always provide you with the opportunity to adjust your e-mail preferences. Please read our complete privacy statement for more information.

Enter your NPI and click “Search.” You will be asked to verify the name associated with the NPI you entered.

Once verification is complete, the registration form will populate with information from the NPI database. Please update any fields that are not accurate or current.

You must also key in your e-mail address, choose a site password, and select Add Clinic to review and submit clinic details.

*Required Field

*Enter a 10-digit, numeric NPI:

Don’t know your NPI? Find it now.

Provider Information

*Prefix
*First Name
*Last Name
*E-mail Address	Note: The e-mail address you provide will be needed to log back into your account, along with your site password.
*Confirm E-mail
*Password	6+ characters, 1 or more numbers
*Confirm Password
*

TAP and HLA-AWARE™ results will be sent by the performing laboratory directly to your selected clinic location. You may also add clinic locations at any time on your profile page once you’re registered and logged in.

*I agree to the following terms:

By completing this registration, you are acknowledging that ViiV Healthcare will maintain the information you have provided for the purposes of professional communication and agreeing that ViiV Healthcare may send you notification of site updates and periodic messages and contact you as needed to update or maintain your registration information. ViiV Healthcare will not sell or share this information with third parties for their marketing purposes and will always provide you with the opportunity to adjust your e-mail preferences. Please read our complete privacy statement for more information.

For additional assistance, call the ViiV Healthcare Customer Response Center at 1-877-844-8872.

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