Email account change request 2026

1. Click ‘Get Form’ to open the email account change request in the editor.
2. Begin with Part 1 – Applicant Information. Check the applicable boxes for existing accounts or changes needed, and fill in all mandatory fields marked with an asterisk.
3. Complete section 1A by entering your legal name, preferred name, date of birth, organization name, and contact details. Ensure all fields are filled accurately.
4. In section 1B, select two challenge questions from the provided list and enter your answers to verify your identity.
5. If applicable, complete section 1D for any new pharmacy ON/ODP# due to address changes.
6. Sign the Notice of Collection in section 1E and ensure you provide the date signed and your signature.
7. Once completed, return pages 1-3 of the form to the OPDP Registration Unit as instructed.

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