Vendor Registration by Mail

Vendors may follow the steps below to register with the UW Health Vendor Liaison Office by mail.

 

Read the following policies:

Complete and sign the Vendor Representative Registration Form:

Complete and sign the Visiting Vendor Representative Confidentiality Agreement:

 

Visiting Vendor Representative Confidentiality Agreement (pdf)

 

Vendor representatives that request patient contact will need to submit documentation of the following:

  • Completion of the yearly UWHC Safety and Infection Control training. Vendor representatives will be required to complete the training and bring the printout of certification to the VLO at registration.
  • Vaccination against or documented immunity against measles, mumps, and rubella.
  • Vaccination against or documented immunity against varicella.
  • Vaccination against or documented immunity against Hepatitis B or completion of the 
  • A negative tuberculosis skin test or proof of being non-infectious.

Additional Registration Steps

  • Clip a standard ID style photo to the first page of the registration. A passport style photo is preferred. Do not send copies of federal or state identification. Any registrations with unsuitable photos will not be processed.
  • Clip a check for payment to the first page of the registration. The check must be made out for $250 to UWHCA (University of Wisconsin Hospital and Clinics Authority).
  • Do not send credit card information through the mail.
  • Send all materials to Vendor Liaison Office, 600 Highland Avenue, Mail code: 1639, Madison, WI  53792.
  • Allow 10 to 15 business days for process to be completed and badge to be mailed