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Optum Idaho Paraprofessional Registry - Identification Information

Please enter the following Information to Proceed. All Fields are required.

IMPORTANT NOTE: This Information is used to retrieve your submission if you are disconnected during the process or wish to wait to complete the form at a later time.

The combination of your TIN# and Email Address uniquely identifies you and your requests in the system. Please use the same information each time, so that you can view your existing information that was submitted if needed.

Important Note: Please use Chrome with this form. Internet Explorer is not recommended due to performance issues.