Ssr portal 2025

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The SSR Referring Physician Portal User Access Agreement outlines the responsibilities and obligations of users accessing the SSR Synapse Portal. It emphasizes the importance of protecting patient privacy and health information in compliance with state and federal laws, including HIPAA. Users must maintain the security of their login credentials, access patient records solely for treatment purposes, and report any violations or incidents. The agreement also states that SSR can terminate access at any time for breaches of the agreement or applicable laws.

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Click ‘Get Form’ to open the SSR User Access Agreement in our editor.
Begin by entering today's date at the top of the form. This is essential for record-keeping.
Fill in your personal information, including your first, middle, and last name, as well as your email address. Ensure accuracy to avoid any issues with access.
Provide your title, phone number, and fax number. This information helps SSR verify your identity and maintain communication.
If you are a provider, include your NPI number in the designated field to confirm your credentials.
Sign the form electronically to indicate that you agree to the terms of the User Access Agreement. This step is crucial for compliance.
Finally, print and fax the completed form to South Sound Radiology at (360) 493-4603 for processing.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (60 Votes)

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