ProviderLink User Support Request Form

User Support Request

If you are a current ProviderLink user and need assistance, there are several ways to get help depending on the type of problem or question that you may have. Please review the user support options listed below to help you select the one which is most appropriate for your problem or question.

NOTE: You must have a ProviderLink user name to request assistance.

If you need your PASSWORD RESET OR UNSUSPENDED, contact your ProviderLink facility administrator within your company.
If you need to report a problem or submit a question regarding the ProviderLink application, please complete the form to the right.
NOTE: ProviderLink will never ask for your password! DO NOT include your password on this form.

User Support Request Form
*Your Name:
Email:
*Phone:
*Company:
*Subject: (e.g., Can't delete task)
*Describe your problem: (Provide details such as steps taken, screen names, error messages displayed, etc.)
Please provide the following information about the software on your computer and the ProviderLink application, if known.
Type of ProviderLink function:
Version of Windows:
Version of Internet Explorer:
*ProviderLink User ID: (e.g., dgriffin@mercyHospital)

* = required field