VIP A CCOUNT E NROLLMENT E LECTRONIC D EATH R EGISTRATION S YSTEM (EDRS) F UNERAL H OMES E DITION...
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VIP A CCOUNT E NROLLMENT E LECTRONIC D EATH R EGISTRATION S YSTEM (EDRS) F UNERAL H OMES E DITION Massachusetts Dept. of Public Health Registry of Vital
VIP A CCOUNT E NROLLMENT E LECTRONIC D EATH R EGISTRATION S
YSTEM (EDRS) F UNERAL H OMES E DITION Massachusetts Dept. of Public
Health Registry of Vital Records and Statistics WEBINAR - VIDEO
VERSION
Slide 2
VIP A CCOUNT E NROLLMENT W EBINAR R EQUESTS Mute ONLY with the
star 6 UnMute Only with the star 6 Please hold questions for the
end
Slide 3
There are four forms to fill out Three on paper to be mailed to
RVRS: 1. Virtual Gateway (VG) Services Agreement 2. Designation of
Access Administrator Agreement 3. VIP User Agreement Registry of
Vital Records and Statistics ATTN: Hansy Noel 150 Mt. Vernon
Street, 1st Floor Boston, MA 02125-3105 One form to be filled out
in Excel and emailed to RVRS 4. User Request Form
[email protected]
Slide 4
VG Services Agreement Virtual Gateway Service terms Contract
between your organization and the Commonwealth. One per
organization Submit the paper original
Slide 5
Designation of Access Administrator Agreement Identify your
Access Administrator Access Administrator manages all of your users
Document to be signed by your owner or director One per
organization Submit the paper originals by USPS
Slide 6
VIP User Agreement RSVS user agreement terms and conditions.
Every person is required to read and sign. One per or Administrator
Submit the paper original
Slide 7
USER REQUEST FORM One per organization Email the Excel file
from the ACCESS ADMINISTRATOR Access Administrator emails the User
Request to
[email protected]@massmail.state.ma.us
Required to generate the VIP and VG user accounts. Form is used for
future user changes.
Slide 8
Virtual Gateway (VG) Services Agreement 1 Designation of Access
Administrator Agreement 2 Vitals Information Partnership (VIP) User
Agreement 3 User Request Form (to be sent electronically) 4
Overview of Steps
Slide 9
1 Virtual Gateway (VG) Services Agreement
Slide 10
Chapman, Cole, and Gleason Funeral Home 12345-67 David Chapman
Director, President 8/23/2013 Chapman, Cole, and Gleason Funeral
Home 2599 Cranberry Highway Wareham, MA 02571 VG Services Agreement
Enter the name of person to receive a copy of the agreement and
address David Chapman Enter the legal business or organization name
followed by the tax ID #. Complete with signature of a person
authorized to sign legal documents for the organization, printed
name, title and the date
Slide 11
VG Services Agreement (Completed Sample) 1 Enter Name of
Authorized Representative Enter Name of Organization Represented
Enter Address of Organization 2 Enter the name of the Organization
Enter the FEIN or Tax ID # Authorized signature of Representative
Printed Name of Representative Date signed Leave the Commonwealth
portion blank
Slide 12
2 Designation of Access Administrator Agreement
Slide 13
This information is the same as the VG Services Agreement (Page
1 of 2) Designation of Access Administrator Agreement The person
who will be designated ACCESS ADMINISTRATOR signs followed by
printing name and title Chapman Cole & Gleason 12345-67 David
Chapman Director, President 8/23/2013 Christopher Berg Funeral
Director
Slide 14
Designation Access Administrator Agreement (Completed Page 1 of
2) 1 User: Enter the organization name it is the name on the VG
Services Agreement 2 Enter the FEIN # or the TAX ID of the
organization 3 The authorized signatory of the organization signs
and then prints name, title and dates the form 4 The person who
will be designated ACCESS ADMINISTRATOR signs, then prints name and
title
Slide 15
David Chapman David Chapman 6 29 12 (Page 2 of 2) Designation
Access Administrator Agreement Select to either designate or remove
an Access Administrator The signatory of the organization fills
this section in This is the information for the person you wish to
designate the access administrator Designate a person as backup to
ease future transitions David Chapman Chapman Cole & Gleason
Funeral Home 781-999-99996-29-2013 Chapman, Cole & Gleason
Funeral Home 2599 Cranberry Highway Wareham, MA 02521 Christopher
W. Berg [email protected] 508-999-9999 508-999-9991 0060
5082 Chapman, Cole & Gleason Funeral Home 2599 Cranberry
Highway Wareham, MA 02521 William Morris [email protected]
508-999-9999 508-999-9991 1582 6469 Authorized Signatory Signs,
Prints and Dates the Form
Slide 16
(Completed Page 2 of 2) Designation Access Administrator
Agreement 1 An Authorized Signatory chooses to either DESIGNATE or
REMOVE an ACCESS ADMINISTRATOR & provides contact info 2 Enter
the name of the organization followed by its address and finally
the name of the access administrator. Two 4-Digit pins must be made
up and cannot include (1234, 0000) 3 This section should be
completed to provide a backup ACCESS ADMINISTRATOR in the event the
main person is unavailable and during times of transition. Complete
the same as above 4 The authorized signatory of the entity signs
granting above named person(s) Access Administration
privileges'
Slide 17
David Chapman Chapman Cole & Gleason Funeral Home
781-999-99996-29-2013 Chapman, Cole & Gleason Funeral Home 2599
Cranberry Highway Wareham, MA 02521 Christopher W. Berg
[email protected] 508-999-9999 508-999-9991 0060 5082
David Chapman David Chapman 6 29 12 Designation Access
Administrator Agreement (Removal of Administrator) Select the
remove option The signatory of the organization fills this section
in This is the information for the person you wish to REMOVE as
access administrator Authorized Signatory Signs, Prints and Dates
the Form
Slide 18
3 VIP User Agreement
Slide 19
(Page 1 of 2) VIP User Agreement Christopher W Berg Chapman
Cole & Gleason Funeral Director 508-999-9999
[email protected] Enter the users: Full Name Name of
Employer Users Title Contact Number Contact Email Fill this form
out for each user of the VIP System. Users may not share
accounts.
Slide 20
(Completed Page 1 of 2) VIP User Agreement 1 User reads terms
and conditions of agreement 2 Enter the Users Name Employer Title
Contact Number Contact Email
Slide 21
(Page 2 of 2) VIP User Agreement Select the appropriate level
of access for each individual user in this example we choose the
fourth selection representing funeral homes The user then reads all
agreement requirements and finishes with a signature and date
Christopher W Berg 6/29/13
Slide 22
RVRS User Agreement (Completed Page 2 of 2) 1 Choose the
appropriate access being requested for User 2 User reads all 10
agreements 3 User Signs and Dates Form
Slide 23
4 Vital Information Partnership (VIP) User Request Form
(URF)
Slide 24
Instructions: 1. All non-role fields are required. 2. Fill in
form, put an "X" in the column with the requested action. 3. Save
document as YourOrganizationName_MMDDYY. 4. Email completed form
to: [email protected] PLEASE SUBMIT ONE FORM PER
EMAIL Questions? Call the EOHHS Virtual Gateway Customer Service
PHONE800-421-0938 TTY617-847-6578
Slide 25
User Request Form We will break this down into three parts as
this will be completed and submitted electronically as an excel
file
Slide 26
Christopher W Berg 8955 0525 [email protected]
508-999-9999 Enter the name(s) of each user Enter 4 digit pin for
user (pin CANNOT be 0000 or 1234) Enter User(s) Month and Day of
Birth (e.g. May Twenty-fifth = 0525) Enter User(s) Work Email Enter
User(s) Work Phone # User Request Form
Slide 27
X X Select from the list the proper group for the user(s) In
this example we are selecting a funeral home data entry Select
option to add or modify user(s) account User Request Form
Slide 28
Instructions: 1. All non-role fields are required. 2. Fill in
form, put an "X" in the column with the requested action. 3. Save
document as YourOrganizationName_MMDDYY. 4. Email completed form
to: [email protected] PLEASE SUBMIT ONE FORM PER
EMAIL Questions? Call the EOHHS Virtual Gateway Customer Service
PHONE800-421-0938 TTY617-847-6578 David Chapman
[email protected] 781-999-9999 Chapman Cole & Gleason
12345-67 8-13-2013 The Access Administrator finishes the User
Request Form (URF) & Save document as described & Send the
document to VIP Project team email User Request Form
Slide 29
VG Services Agreement Required for each organization accessing
VIP and/or the EDRS Designation of Access Administrator Required to
establish and maintain access to the VIP and/or EDRS A backup
should be administrator is strongly recommended VIP User Agreement
Each individual person who will be accessing the VIP and/or EDRS is
required to agree to the terms and conditions of the VIP system.
SHARING ACCOUNTS IS NOT ALLOWED User Request Form To be emailed by
the Access Administrator from the email account on file with the
Virtual Gateway Checklist before submission
Slide 30
MAIL FORMS TO: Registry of Vital Records and Statistics ATTN:
Hansy Noel 150 Mt. Vernon Street, 1st Floor Boston, MA 02125-3105
EMAIL TO: [email protected]
Slide 31
T HANKS ! WE LOOK FORWARD TO J ANUARY 1 ST AND OUR NEW E
LECTRONIC D EATH R EGISTRATION S YSTEM THE V ITALS T EAM
[email protected] QUESTIONS?
Slide 32
Quick Reference Guide VIP Enrollment FORMS Funeral Homes
Registry of Vital Records and Statistics IGNORE ALL OTHER
ADDRESSESS ATTN: Hansy Noel * USE ONLY THIS ADDRESS * 150 Mt.
Vernon Street, 1st Floor Boston, MA 02125-3105
[email protected] BY PAPER ( * 3 weeks to process the set
* ) VG Services Agreement Contract between you and our MA IT
Services * need your Tax Id # and level III or VI director to sign
* Designation of Access Administrator Manages user access, addition
& removal * designate one, with one or more backup admins * VIP
User Agreement Every user promises to follow policies * every user
acknowledges on paper * BY EMAIL ( * 2 days to process * ) User
Request Form Access Admin manages users by excel & email