Kaiser Permanente Nurse Anesthetists Association

KPNAA Members, on August 26, 2005, we changed how Members will access the KPNAA Members Only website. Access will be by Username = your Last Name and Password = the Pin# you assign yourself below. Absolutely no one will be granted access until they have completed the form below totally and had their Membership verified. So please take a minute and help us get this system running as well as update your contact information in the database.
* Denotes Require Field
* Name:
Old Employee Number:
*Address:
* City:
* State:
* ZIP Code:
* Home Telephone:
* Work Telephone:
* FAX:
* E-Mail:
* Verify E-Mail Address:
Below you are requested to enter a PIN# to allow you access to the KPNAA Members Only Website. You may use numbers and letters but it must be a minimum "6" six digits and maximum "15" digits, but please do not use sequences like these: abcdef / 123456 / 777777. Once your membership has been verified and setup you will be allowed to enter the Members Only website. Please allow two working days for this transaction.
* Members Only Website PIN# PLEASE DO NOT USE THE NUMBER "0" AS THE FIRST DIGIT.
* Verify Pin#
Other Information You Would Like to Provide the Management Office