If you are interested in signing up for HEALTHeNET, please complete and sign the following documents based on the method of access desired.

User Interface

For access to HEALTHeNET through the online portal, please complete the following documents:

 Net Exchange (Direct Connect)

For access to HEALTHeNET using a system to system API, please complete the following documents:

Please Note: there could be costs associated with a system to system connection. More information is available upon submission of the request.

Please submit completed forms and questions to:

  • Email to
  • Fax to (716) 206-0996 with Attention: HEALTHeNET Account Request
  • Mail to HEALTHeNET, 2475 George Urban Blvd., Suite 202, Depew, NY 14043