Register Online as an Authorized Agent

Health care organizations can appoint an authorized agent to query and/or report to the Data Bank on their behalf. To become an authorized agent, you must first register online with the Data Bank. There are guidelines that a health care organization can follow when designating an authorized agent, see Designate an Agent for detailed instructions. See Find an Agent for more information on available agents.

To Register as an Authorized Agent

To register as an authorized agent with the Data Bank, follow these steps:

    1. On the Data Bank home page, click Register.
    2. Click the Register as an Authorized Agent link.
    3. Read and acknowledge the Rules of Behavior.
    4. The Agent Registration page appears.
    5. On the Agent Registration page, complete all applicable fields. Click the Help button if you need more information about completing the registration.
    6. When you complete the Certification section, click Continue.
    7. On the User Account Information page, fill in the requested information on this page and click Continue.
    8. On the Print Registration page, carefully read the steps and click Registration Form. Print two copies of your form. Your new Data Bank Identification Number (DBID) is found on this form.
    9. Return to the Print Registration page and click Continue.
    10. Sign and date one copy of the Agent Registration form and mail it to the specified address; keep the other copy for your personal records.

Note: The form must be received within 6 months of completion or it cannot be processed. Please do not enclose pre-paid, self-addressed envelopes for overnight return mail delivery. If received, these envelopes will be returned to you unused.

    1. You will receive an email that confirms your registration once your signed Agent Registration form has been processed.

Note: Authorized agents should have only one DBID, even if they are an agent for more than one organization. If an authorized agent has been issued more than one DBID, he or she should immediately alert the Dank Bank, identify which DBID will be used, and request that any other DBID(s) be deactivated.

Already Registered?
If you are already registered, your Data Bank Administrator can sign in to the Data Bank and update your registration and your health care organization information via the Update Registration Profile tool on the Administrator Options page. See Renew Registration for more information.