ePA Portal

PAReferenceID:

Enter User Name:

Enter Password:
User names and passwords are required for Surescripts accounts.

Paste the ePA 2013 XML below

Request Submitted Successfully
Message from Acknowledgement:

Enter 2017 User Name:

Enter 2017 Password:

Enter 2017 Header/To Value:

Enter 2017 Receiver/TertiaryIdentification:

[Optional - Upload a file, 2 MB Size Limit]:
Status: File not attached to PARequest.