IntraMalls

New Account Request Form  
Help Desk Phone Number: (888) NIH-MALL - (888-644-6255)

Please fill out all the information below in order to request a new user account. You may make additional comments in the "Comments" field.
DO NOT put password, credit card, or any other sensitive information in the comments field. This is not a secure connection. Important: If you HAVE AN ACCOUNT but are experiencing difficulties accessing the IntraMall
please go to our Trouble Report Page

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Do you have a Government credit card?Yes No
Default Project/CAN Nbr: Omit if unknown
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