Sentri II Add Staff Form

For removal requests, view the Sentri II Staff Removal Form

Provider Name: *
First/Last Name: *
Hire Date: *
Job Title: *
Staff's Program / Team Assignment: *
Staff's Phone: *
Staff's Email: *
AIM Staff Type: * [Help]
Supervisor: *
Same account type as
current employee:

Requested By
First/Last Name: *
Email: *
Phone: *

Does this user require ability to enter claims via Sentri?
Would you like this user to be signed up for claims training?