Please, complete this form to create your PHDB Query Account!

  • You will only need to fill this out once! Next time you simply sign in!
  • This single account will be able to query all hospitals on the PHDB!
  • No more having to remember passwords and websites for every different hospital.
Why do I have to fill out this information and create an account?
Our Participating Hospitals have requested to know who is querying their information. By creating an account, your query event information is available to the hospital from which you printed a letter for audit purposes. If you have any questions, please call us at 800-995-4233 ext 205.
Per Letter Rate for Primary Source Verification
Standard Rate $3.00
Processing Time Print Instantly
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5 Questions Every Hospital Should Ask Themselves
New Account Information
Already have an account? Click here to Sign-in
Email Address:  
Create Password* (Must be at least eight (8) characters long, may contain numbers (0-9) and upper and lowercase letters (A-Z, a-z), but no spaces. Make sure it is difficult for others to guess!)  
Logon User Password:  Confirm:  

Pick a secret question - This is used in case you forget your password and need to retrieve.

(Choose a question only you know the answer to and that has nothing to do with your password)

Secret Question: Answer:  

Return Address Information
This information will show up as the return address on all letters that you print out.

  • If you would like "Medical Staff Services" to show up instead of your name, please enter "Medical Staff Services" for the "First Name" and leave "Last Name" blank.
  • Please fill out the following with accurate information so we can properly address your verification letters:
  • click here for sample letter

Company Name  

First Name

Last Name

Address 2 City  
State: ZIP:  

By submitting this form, I agree to the Terms of Service.  
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