Group Health Cooperative - Developer Registration

*Application Name:

Description:

*Organization Name:

Application Platform:

Depending the targeted platform or device, additional configuration may be required such as redirect URIs, specific authentication settings, or platform specific fields.

Website:

Developer Name:

*Developer Email:

*Callback URLs (Please enter one URL per line.:

Privacy Policy URL:

Terms of Service URL:

Transparency security attestations and certifications:

Customer Support Email:

Customer Support Phone:

Notes:

Enter security code:

Register an Application