Please rate Form Irm 15 3-2025
Part A is completed by the person to be given access; Part B is completed and sent directly only by the External Access Approver (EAA).
Agency requesting access: select and complete only one option, 2a or 2b.
Access level: check only one option for any system access.
Where to send: the form must be sent directly to the NYS OASAS Provider Help Desk by the External Access Approver or it will be returned without processing.
Disabled: if a user does not access an OASAS system during a consecutive 90-day period, the account will be disabled.
Closed: if a user does not access an OASAS system during a consecutive 400-day period, the account will be closed, and access rights terminated.
| Question | Answer |
|---|---|
| Form Name | Form IRM-15 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 49 |
| Avg. time to fill out | 9 min |
| Edition | Rev 3/2025 |
| Issuing agency | OASAS |
| Where to send | NYS OASAS Provider Help Desk |
| Matches the agency's file | Yes, checked October 3, 2026 |
| Other names | IRM-15, IRM 15, IRM15, Form IRM-15, OASAS External User Access Request |
| Official source | Form IRM-15 (Rev 3/2025), OASAS |
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Please rate Form Irm 15 3-2025
