DHEC home link
Help Wednesday, April 23, 2014 Not logged in
  • HOME
  • REGISTRY
New SCI PAS Account Creation

If provider has accessed SCI PAS previously, please click on HOME to return to log in page.
For assistance, please contact the Help Desk at 866-439-4082 (select option 2, Immunization Registry).

New providers to SCI PAS need to complete the following information to create an account to register in:
  • South Carolina Immunization Registry (SCI Registry).


All fields in bold must be completed to submit for SCI PAS account creation.

Facility Name :
(as it appears on W-9)
Practice Name (or Doing Business As):
(If Different from Facility Name above)
 
Name of Electronic Signature Authority (ESA):
(first)

(middle)

(last)
Position / Title of ESA:
Federal Employee Identification Number (FEI): Organization's NPI:
Facility Address (no P.O Box):
City: State: Zip:
County:
Facility Phone Number:
Email Address
(this will be your user name)
Password:
(enter password)

(re-enter password)
Enrollment/Registration Type: