CT HMIS – LMS Registration Form

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CT HMIS - LMS Registration Form

This form is for New LMS Users. If you already have access to the LMS, there’s no need to fill out this form again.

Name(Required)

First Last

Email(Required)

Are you a NEW user requiring training to access the CT HMIS Database(Required)

(Provide Details)(Required)

Organization Name(Required)

Other Organization Name(Required)

Continuum of Care (CoC)(Required)

Job Role(Required)

Your Phone Number (Mobile Phone Preferred)(Required)

Your HMIS Data Coordinator's Email(Required)

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