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H/C PRI and SCREEN ID Reissue Request
ONLINE Trainees of PRI and SCREEN: You can access your card yourself by clicking here.

Please complete the form below to request a re-issued card with your H/C PRI Assessor Identification Number or Screener ID, or to request a name change.

Select the training in which you are requesting a re-issued ID card (select all that apply)

H/C PRI
Screen

Please enter the e-mail address you would like the ID card sent to
The re-issued card will be emailed to the address you provide, please check that it is entered correctly.

Phone Number (with area code)

Date of Training(s)

Before 2004
2004 through 2015
2016 or after
Unsure

Please enter your name as it appeared on your previous ID card.

If you would like your name changed, please enter the name as you would like it to appear on the re-issued ID card.