Request a certificate for a Health Care Organization
Request a new certificate to be used for Direct mail for a new organization or individual

Direct Messaging Certificate Information required to create a certificate which will digitally 'sign' Direct messages for an organization.

Organization

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.

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.

Other Info