Request a New Billing Matrix Account

This form is used for requesting a new Washington University Billing Matrix Sign-in Account. If you need to review study profiles, matrices, and/or enroll patients or enter departmental budgets, track patients, sponsor/internal department billing then you will need a Billing Matrix Account.

Please enter the information below and click Submit when finished.
All fields are *required and vital in supplying the correct security for you.

**If you are unsure of your Domain Name and Username, please contact your computer Help Desk for assistance in acquiring the correct Domain Name and Username.  If you do not see your Domain Name in the list, please contact the Billing Matrix IT Office: billingmatrixithelp@wustl.edu. 

*Last Name
*First Name
*Employee ID
*Department
*Division
*Email Address
*Type of Access
**Domain Name
**Username
*Phone Number
 

     

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