External Student/Provider HIPAA Training

HIPAA Training for non-WesternU individuals providing patient care services in conjunction with WesternU Health members or facilities.
Title
A short description to explain the nature of a ticket.
Non-WesternU HIPAA Training Request (2021-2022)
Please select from the list which center you will be operating out of during your time at WesternU Health.
Please enter the name of the site you will be operating out of.
Please enter the date you will be arriving in clinic
What is your primary role or function within the center you are working in?
Please enter your NPI
Please enter your license information.
Please enter the state your license was issued.
Please enter your license expiration date.
Please enter your DEA Number (if applicable).
Please enter any additional information that may be helpful in processing your request.

Other Fields

Your name
Verification Code