SC WCC

User Registration

FAQs

First Name:*

Last Name:*

Email Address:*

**This will be your username**

Job Title:

Address 1:*

Address 2:

City:*

State:*

Zip:*

Phone:*

Fax:

Password:*

Re-enter Password:*

I represent a:*

Law Firm

Carrier or Self-Insurer

TPA - Claims

Company:*

Address Same as User

Address1:*

Address 2:

City:*

State:*

Zip:*

Phone Same as User

Phone:*

Is This FEIN Used for EDI Claims Reporting

FEIN:*

Manager Name:*

Manager Email:*