Request Access: Step 1

This step is for new practices only. If your practice is already using CooperCare Link, click here to log in.

Please complete the forms below. You will be asked to designate a site administrator. The site administrator is an individual employed by the site who shall act as the liaison between Cooper and the authorized users. Responsibilities of the site administrator include requesting new user access, suspending existing user access, requesting termination of existing user access, and changing existing user passwords.

Practice Information

Please enter information about your practice.


Site Administrator

Please supply information for the person who will be responsible for configuring the system and managing users.


Note: You will be able to add additional users once your practice has been granted access.

I agree