NEW AGENT REGISTRATION

If your agency is currently contracted with Britt/Paulk, please complete the following short application to register and to begin using OPUS.

• = Required Information

Agency Identification Number:	• ***
Agency Name:	•
First Name / Last Name:	• •
Phone Number:	•
Email Address:	•
Retype Email Address:	•
Requested User ID:	•
Requested Password:	•
Retype Requested Password:	• Passwords must be 7-15 characters long, and can only contain letters and/or numbers
Personal Security Question:	•
Answer:	•

***Call Customer Service at 1-800-842-8917, if you don’t know your Agency ID.