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Ultravisual Web Access Request

To request access to Ultravisual Web, users need to complete this access request form.

Once submitted, requests will be evaluated for RSA token assignment and Ultravisual Web log-in ID. This information will allow Allina Information Systems to configure your Ultravisual Web access. If a new RSA token is required, it will be shipped to your primary clinic address that you provide in this form.

Instructions and other information will be provided in your RSA token package.

Please note our recommended minimum hardware and network requirements for Ultravisual Web (requires Adobe Reader) .

Physician Name:
Allina D number:
Phone:
Email Address:
Hospital or clinic where you currently access Electronic Medical Imaging (EMI):
Primary Clinic Name:
Primary Clinic Address (for RSA token shipment):
City:
State:
Zip Code:

Comments (250 characters):
 

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For technical assistance call:
612-262-1900
1-800-315-4085
E-mail: emisupport@allina.com