If you need access to Epic applications or documentation for the purpose of supporting an Epic customer, please submit this application for access.

Each firm only needs to submit one application per customer, even if you have multiple consultants working with that customer who need Epic access. If your firm's Epic access needs change for a customer, and you need additional Epic access not previously included in an agreement with Epic, please submit a new application for access. Epic will review each fully completed application and either send you an executable agreement to permit the customer to give your staff Epic access or notify you of next steps.

If you have questions, please email consultantinquiries@epic.com or contact the Consultant Relations team at 608-271-9000.

All fields are required except where otherwise noted.

Firm Contact Information

(Include Inc., LLC, Corp., etc.; if you are an independent contractor, please list your full legal name.)
(If you are an independent contractor, please list your primary mailing address. Please spell out state.)

Please provide the contact information for an authorized executive at your company to serve as the corporate contact. Should Epic approve your request for access, this individual will receive the drafted agreement for signature. If they are not the appropriate signatory, they may forward to the appropriate person at that organization.

Applicant Contact Information

Please provide your name and contact information. We will contact you with any questions about the submitted application.

Overview

Epic Customer Information

Project Information

Subcontracting Information

Consultant Firms and their Subcontractors must submit separate access requests. Independent contractors working through a different firm are considered Subcontractors.

NOTE: The Consultant Firm is the company that has the contract directly with the Epic customer.

Subcontractor Company Services Being Subcontracted
Contractor Company Services Being Subcontracted

Access Requested

If your organization will provide multiple roles at the customer, you can request multiple access groups on this application.

Specify at least one access group.

Notes

Please provide any additional notes or details pertinent to the Epic access requested.