User Information

Please enter your personal information below
* Indicates Required Field
 
* First Name:
* Last Name:
* Organization/Squad:
* Address:
 
* City:
* State:
* Postal Code:
* Phone:
Fax:
Pager:
* Email:

User Access

Your username and password will be used to access the system
Passwords should be at least 6 characters and be alphanumeric
 
* Username:
* Password:
Confirm Password:
 

Applications

Please select the application(s) you wish to access
 
Selective DiversionBed AvailabilityMass Casualty
ARHA
 

Facilities

If you are requesting edit rights, please select the facility and application types below. Otherwise, leave the checkboxes blank. You will be granted read-only rights to all facilities within each application that you selected above.
 
Selective DiversionNDMS
Bed Availability		Local Mass Casualty -
ED Capability
Affinity Medical Center  
Akron Children's Hospital
Akron City Hospital
Akron General Medical Center
Alliance Community Hospital  
Aultman Health Foundation  
Barberton Citizens Hospital
Humility of Mary - St. Elizabeth  
Lodi Community Hospital
Medina General Hospital
Mercy Medical Center
Robinson Memorial Hospital
Saint Thomas Hospital
Salem Community Hospital  
Summa Western Reserve Hospital
Wadsworth-Rittman Hospital
 
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