Hello,
Welcome To CompHub
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Request Number is 123456
User Registration
  • Login Information
  • Personal Information
  • Address Information
  • Role Information
  • Identity Verification & Submit
Login Information
You will provide this information to login into CompHub Work Portal.
Email
*Required
Create Password
*Required
Confirm Password

*Required
Personal Information
This information should match with the identity verification document that you will be providing.
First Name
*Required
Middle Name
Last Name
*Required
Gender
*Required
SSN
Date of Birth
*Required
Phone

*Required
Address Information
This information should match with the identity verification document that you will be providing.
Line 1
*Required
Line 2
City
*Required
State
*Required
Province
*Required
Country
*Required
Postal Code
*Required
Role Information
Provide the role you are requesting to access the CompHub Work Portal.
Role
*Required
Do you have code sent by us via mail?
Yes No
*Required
Voc Rehab Provider Name
*Required
Line 1
*Required
Line 2
City
*Required
State
*Required
Postal Code
*Required
Phone

*Required
Employer Name
*Required
Line 1
*Required
Line 2
City
*Required
State
*Required
Postal Code
*Required
Phone

*Required
Further Info
*Required
Application Type
Waiver Application
Practitioner Registration
*Required
Further Info
*Required
Identity Verification & Submit
Identity Document Type
*Required
Upload Identity Verification Document
*Required

Usage of this system constitutes acceptance of the Online User Services Agreement. WCC retains the right to suspend any user found to be in violation of the Online User Services Agreement.

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Usage of this system constitutes acceptance of the Online User Services Agreement. WCC retains the right to suspend any user found to be in violation of the Online User Services Agreement.

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