Rosetta Health Admin Portal
Request a certificate for a Health Care Organization
Request a new certificate to be used for Direct mail for a new organization or individual
Requests
Certificate
Direct Messaging Certificate
Information required to create a certificate which will digitally 'sign' Direct messages for an organization.
Please select
Organization
Address
Basic
Medium
Please select
1 Year
2 Years
3 Years
Organization
Health Care Organization*
Legal Assumed Name (DBA)
Address
NOTE:
Please fill in the legal address for the HCO requesting the digital certificate. The address is used to verify the business is legitimate and in good standing. Therefore, this address must match the address of record maintained by the appropriate state and local agencies.
Country*
Address 1*
Address 2
City*
State*
Postal Code*
Authorized Representative
NOTE:
Please fill in the information for the person
to be proofed
, and who will be responsible for the digital certificate. The Authorized Representative must be an employee of Health Care Organization (HCO) listed above.
First Name*
Last Name*
Phone Number*
Email*
Other Info
Vendor*
Vendor Email
Requested Subdomain*
Special Instructions
Terms of Service
By checking below, I agree as follows: The organization is a HIPAA covered entity, a HIPAA business associate, or a healthcare-related organization which treats protected health information with privacy and security protections that are equivalent to those required by HIPAA. If the organization is a healthcare-related organization, the organization limits its use of the Certificate to purposes related to Direct messages and has agreed to handle protected health information with privacy and security protections that are equivalent to those required by HIPAA. I acknowledge that the organization may terminate my agency to request certificates on its behalf and immediately forward any requests for termination to DigiCert. The organization has authorized HISP as its certificate agent and agreed to the subscriber agreement. I will only use certificates requested for the organization for the benefit of the organization. I will make the organization aware of the certificates requested on its behalf and promptly forward any requests for certificate revocation made by the organization to DigiCert.
Service Terms
I Agree
Do Not Provide Security Email*
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