Referral Application New User Form

Hello Referral Application Administrators!

As of October 1, 2018, all updates to users in the iNexx Command Center need to be coordinated with GLHC Support.  Please complete this form prior to adding a new user to the iNexx Command Center.  GLHC Support will verify that the requested user name is available.

  • Referral Application Admin Information

  • User Information

  • This field is for validation purposes and should be left unchanged.