Navajo Access Request FormPlease note only access requests submitted from approved NHA employees will be completed. Submitter Information What is your name? First Name Last Name Email * User Information User Email * Is this a request to enable a user for all HMOs because they were disabled from one? (Known bug) * Yes No Should this user have "All Sites" Report Access? * Yes No Site and Reporting Access Please select for each site, wherther the user should have access the individual site and/or have access to reports Chinle Reports Access Site Access Crownpoint Reports Access Site Access Kayenta Reports Access Site Access Dilcon Reports Access Site Access Ft. Defiance Reports Access Site Access Ganado Reports Access Site Access Navajo Reports Access Site Access Ojo Reports Access Site Access Pinehill Reports Access Site Access Pinon Reports Access Site Access Shiprock Reports Access Site Access Thoreau Reports Access Site Access Tohajilee Reports Access Site Access Tohatchi Reports Access Site Access Tuba City Reports Access Site Access Window Rock Reports Access Site Access User Roles Note: Please provide the exact role name from the site in which the role should be applied to ensure the correct permissions are granted to the user. Chinle Crownpoint Dilcon Ft. Defiance Ganado Kayenta Navajo Ojo Pinehill Pinon Shiprock Thoreau Tohajilee Tohatchi Tuba City Window Rock Thank you!
