Arkansas WebIZ Help Desk
Arkansas WebIZ Help Desk
Arkansas WebIZ Help Desk
Submit a ticket
Facility Enrollment Request
Submit a Support Request
Required fields are marked with
Name:
Email:
Confirm Email:
Job Title:
Facility name:
Is this facility in the state of Arkansas:
Yes
No
Facility Phone Number:
What is the best number to reach you at?
store# / clinic# (ex: Walmart #1):
Tell us why you need access:
Subject:
Message:
Suggested knowledgebase articles:
Attachments:
Drag files here or click the 'Add File' button below to select files to upload.
Add file
File upload limits
SPAM Prevention
Type the number you see in the picture below.
Before submitting please make sure of the following:
All necessary information has been filled out.
All information is correct and error-free.
We have:
18.191.32.71 recorded as your IP Address
recorded the time of your submission
(
)