Enroll in DHIN: Save time, save money and provide better care.
By completing this form your practice will be on its way. Once we have received the form the DHIN Provider Relations Coordinator will contact you to get your staff set up with DHIN. If you have any questions about this form or DHIN enrollment, please contact us at (302) 678-0220 or by email at email@example.com.
Download the Word version of the DHIN Enrollment Form here.