ARMS Request for User Access Form
- To access ARMS users must contact their Area Agency on Aging.
- Aging Service Provider Agencies must be current providers of services in this Fiscal Year.
- Complete one form per user. All fields must be filled out.
- Save
the form using the name of the person requesting access (#2)
and the User role (#11).
Example: Provider – Linda Owens-J035; County – Linda Owens-Wake; Region – Linda Owens-J - Do
not Fax or send as a PDF,
send MS Word Document electronically via e-mail to
Annette.Bagwell@dhhs.nc.gov
This form must come directly from the Area Agency on Aging. - Annual verification will be required of all ARMS Users each fiscal year in August.
- Provider Agency shall notify the Area Agency when users leave an agency or the user no longer should have access to ARMS.
- Area Agencies shall submit the ARMS Request for User Access Form when ARMS users status change or leave the agency.
Form Instructions
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1. Type of User Check one User Type |
o New User |
o Change User |
o Remove/De-Activate User |
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2. Name: Type first name, middle initial and last name. Example: Linda M. Owens |
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3. E-mail address: Type a valid e-mail address |
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4. Agency: Type full name of agency |
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5. Title: Type working title |
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6. Phone Number: Type telephone number including area code and extension if available |
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7. Office address Type the street address including city, state and zip code |
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8. Region: Type the Region Code of the Area Agency |
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9. County: Type the County of the Agency |
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10. Provider Number: Type assigned Provider Code - Example: L035 |
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11. ARMS User Role - check only one of the following:
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12. Approved by AAA Director or ARMS Coordinator _________________________ 13. Date____________________________ Type date form completed or submitted
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Last updated November 5, 2009