For use by Existing or Potential Kaiser Permanente Vendors or Partners
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How to use this form:
o Use this form to request Kaiser Permanente (KP) to review of an emerging technology or service.
o Be sure to enter all information before pressing the Submit button.
o Once submitted you will not be able to make changes or additions.
o Fields with a '|' (red bar) are required to submit.
o Mulitple line text boxes may be expanded by dragging the lower right corner.
o Field level help is to the left of many prompts.
o If you experience problems submitting your request email the problem details along with submission details by clicking here.
After submission this request will be reviewed and the technology or service evaluated further by technical resources within Kaiser Permanente IT to determine if it may be of value to Kaiser Permanente.
The contact information provided will be used to collect any additional information needed and to inform you of the final results of the review.
