GeisingerConnect Online Access Request Form


GeisingerConnect Online Access requests are assigned as a Routine Priority.

If you are requesting access for a user/yourself and are with an organization that already has GeisingerConnect, please ask your site administrator to add you through the online process.

If your organization regularly needs to view Geisinger patient information, or if your organization has contracted with Geisinger specifically to view patient information, please complete the fields below to begin your enrollment.

  • Once verified you will receive your account activation information and registration instructions at the email address you provide below within 5 business days.
  • Follow the registration instructions to activate your account, e-sign the agreement, then complete the registration process for all appropriate staff and providers.
  • After you complete registration for the additional users in your organization, they will be sent their account activation to view patient records in 5 business days.

If you have questions please submit Feedback


Step 1: Please complete the fields below to initiate your organization's account (one request per organization):


Your Contact Information


For registration usage only


Step 2: Please select the correct description for your organization from the drop-down.

These are the only organizations that are granted access to Geisinger patient records.

If you wish to contact us please use the Feedback form


First Name Last Name Credentials Geisinger Provider# (if known)

Geisinger contact person