Facility User Registration

In-Center Hemodialysis CAHPS (ICH CAHPS) Facility Website User Credentials Registration Process

To obtain user credentials to access the private links on the ICH CAHPS Web site, each Medicare-certified in-center hemodialysis (ICH) facility must designate a staff member to be its ICH CAHPS Survey Administrator and have that person register by completing the information below. After you submit this registration form, the system will take you to a dashboard specifically created for your facility/organization. The dashboard will contain instructions for completing the next steps in the registration process.

Note that the ICH CAHPS Coordination Team will send user credentials to the registered ICH CAHPS Survey Administrator via an e-mail message as soon as this online form is submitted.

Survey Administrator First Name:
Survey Administrator Last Name:
Survey Administrator Email:
Confirm Email:
Survey Administrator Phone:

Please create and enter below a username and password that you would like to use to be able to access private links and forms on this website.

Requested Username:
Password (minimum 8 characters):
Confirm Password: