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Current Vendor New Log In Request

If you are a currently contracted vendor with AHSA and wish to set up an individual user account, please complete and submit the form below and an AHSA representative will be in contact with you.

IMPORTANT NOTE: Please be aware that current contracted vendor status will be verified before processing any requests.

If you are a staffing provider wishing to be considered by AHSA, please go to the NEW STAFFING PROVIDERS tab to register.

Current vendors please fill out and submit the form below to begin the account creation process.
 

* required

E-Mail Address *

First Name *

Last Name *

Company Name *

Terms and Conditions

I agree to the above Terms and Conditions *


Please type the word from the image in this field.