Community Based Organizations (CBO) staff

Do you have a Person of Interest (POI) number?

• Yes: Enter your POI number on the form in step 3
• No: Download and fill out this POI request form
  • Then email the completed form to dph.requestPOI@sfdph.org

Do you give direct treatment or care to clients?

• Yes: Review these instructions: Provider Screening, Enrollment & Credentialing | San Francisco
  • Then go to Step 3
• No: Go to Step 3

Once you have your POI number,

• Download and fill out this account request form
• Make sure these columns are also filled out:
  • Column P (DSW/POI): Your POI number
  • Column R (DPH AD Account Needed): Yes
  • Column U (DPH Email Account Needed): Yes, only if the person is approved to have a SFDPH email
  • Column W (Epic Access Needed): Yes, only if the person is approved to have Epic access