ECSI Agency User Setup Information

During this fourth quarter of 2011, ECSI has taken the initiative to improve our technological infrastructure. In an effort to better ensure the security of the data and services we provide to your company, ECSI has moved all sensitive information into an area that requires each user to have a unique account to gain access. Please complete the form below for each user in your company that will need secure access to ECSI systems. The completed form must be sent to We will process this information and send an email to the user with login credentials and instructions.

If you have any questions, please contact Client Support at or 800.437.6931.

Thank you.

ECSI Agency User Setup Form

Agency ID:   AG
Agency Name:    
Primary Contact:    
Primary Contact Email:    
Primary Contact Phone:    

User: First and Last Name

E-Mail Address

Administrator(A) or User(U)
(Sample) John Smith A