Manual identity verification for Provider Digital Access form (HW080)

Use this form if you could not verify your identity online for your Provider Digital Access (PRODA) account or your name has changed.

Download and complete the Manual identity verification for Provider Digital Access form.

To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please contact us. We can help you access, complete and submit them.

Page last updated: 3 March 2022