If you are an active registrant, you can download IBM Workplace forms that are pre-populated with your registrant and client information. To locate your forms, enter your registrant name in the field below and click the "Search" button. If you are not sure of the Registrant name, you can view the list of active registrant names in alphabetical order using the links below.
If you have just registered a new client and a link to the pre-populated form is not available, please check the download page again later in the day. The icon will be displayed when the new form is available.
| |
| Client Name |
House ID |
LD-2 Form |
| Alabama Organ Center |
366940248 |
|
| Alice Peck Day Memorial Hospital |
366940209 |
|
| Allen Memorial Hospital |
366940090 |
|
| Aultman Hospital |
366940194 |
|
| Avera Health Plans |
366940229 |
|
| BALL MEMORIAL HOSPITAL |
366940100 |
|
| Baptist Healthcare System |
366940185 |
|
| Berger Health System |
366940121 |
|
| Bingham Memorial Hospital |
366940110 |
|
| Bluegrass Family Health |
366940227 |
|
| Botsford General Hospital |
366940087 |
|
| Catskill Regional Medical Center |
366940140 |
|
| CentraCare Health System |
366940200 |
|
| Central Montana |
366940253 |
|
| Centura Health |
366940050 |
|
| Chinese Community Health Plan |
366940214 |
|
| Coalition for Affordable Health Coverage (CAHC) |
366940128 |
|
| Coalition for DGME Fairness |
366940049 |
|
| Community Care of Oklahoma |
366940218 |
|
| Community Hospital |
366940112 |
|
| Community Memorial Hospital |
366940201 |
|
| Continuing Care Hospital |
366940226 |
|
| COPE Health Solutions |
366940143 |
|
| Craig Hospital |
366940199 |
|
| FirstCarolina Care Insurance Company |
366940217 |
|
| Forum Health |
366940036 |
|
| Franklin Regional Hospital |
366940224 |
|
| Freeman Health |
366940046 |
|
| Gaylord Hospital |
366940154 |
|
| Gift of Life Michigan |
366940250 |
|
| Grant Memorial Hospital |
366940241 |
|
| Greater Regional Medical Center |
366940256 |
|
| Gritman Medical Center |
366940054 |
|
| Hackensack Meridian Health |
366940252 |
|
| Hardin Memorial Hospital |
366940184 |
|
| Health Alliance Medical Plans |
366940220 |
|
| Health New England, Inc. |
366940222 |
|
| HealthFirst Health Plans, Inc. |
366940219 |
|
| Henry Ford Health System |
366940186 |
|
| Hospital Health Plan Coalition (formerlyNational Coalition of Local Health Plans |
366940000 |
|
| Howard Memorial Hospital |
366940257 |
|
| Indian River Medical Center |
366940089 |
|
| Iowa Health System |
366940111 |
|
| Kettering College |
366940235 |
|
| Lafayette Regional Health Center |
366940202 |
|
| Legacy Health |
366940267 |
|
| LifeBanc |
366940247 |
|
| Lincoln Health |
366940230 |
|
| LOPA |
366940249 |
|
| Magnolia Regional Health Center |
366940098 |
|
| Margaret Rollins School of Nursing |
366940232 |
|
| Massac Memorial Hospital |
366940258 |
|
| Memorial Regional Health |
366940259 |
|
| Methodist Hospital |
366940142 |
|
| Methodist Le Bonheur Healthcare |
366940269 |
|
| Mid-America Transplant |
366940246 |
|
| Ministry Health Care |
366940133 |
|
| Morrow County Hospital |
366940260 |
|
| Mother Frances Hospital |
366940213 |
|
| National Alliance for Nursing Education (NANE) |
366940105 |
|
| North Sunflower Medical Center |
366940203 |
|
| Norton Community Hospital |
366940057 |
|
| Ochsner Health System |
366940266 |
|
| Opelousas General Health System |
366940165 |
|
| Osceola Medical Center |
366940211 |
|
| OSF Healthcare System |
366940119 |
|
| Parkview Health System |
366940178 |
|
| Piedmont Healthcare |
366940265 |
|
| Presbyterian Health Plan |
366940225 |
|
| ProMedica Health System |
366940159 |
|
| Promise Healthcare |
366940061 |
|
| Pullman Regional Hospital |
366940208 |
|
| RemoteMD |
366940271 |
|
| Ridgecrest Regional Hospital |
366940264 |
|
| Riverwalk Land Development, LLC |
366940176 |
|
| Roane General Hospital |
366940263 |
|
| Saint Francis Foundation |
366940117 |
|
| Saint Mary's Regional Medical Center, ME |
366940043 |
|
| Selby General Hospital |
366940080 |
|
| Shelby Memorial Hospital |
366940261 |
|
| Shepherd Center |
366940239 |
|
| Sisters of Mercy Health System |
366940127 |
|
| Skyline Hospital |
366940206 |
|
| Sparks Regional Medical Center |
366940109 |
|
| St. Croix Regional Medical Center |
366940210 |
|
| St. John's College of Nursing |
366940231 |
|
| St. Joseph Memorial Hospital |
366940205 |
|
| St. Michael's Hospital |
366940212 |
|
| The Queen's Health Systems |
366940268 |
|
| Tri-State Memorial |
366940207 |
|
| Union General Hospital |
366940262 |
|
| West Park Hospital District |
366940134 |
|