CompOnline Registration

If you have questions about CompOnline or the registration process, please call (952) 838-4200
or (800) 937-1181.

	Required fields in red
	Organization information
Organization name
Policyholder number
Address
City
State
Zip code
	CompOnline user information
Name
Title
Work Address (if different from above)
City
State
Zip code
Phone number
Fax number
Email
	Location information
Does the organization have multiple locations? Yes No
Does this CompOnline user account need access to all locations? Yes No
	If this CompOnline user account is for specific locations only, list them here.
	Access to confidential information
	Check whether the user should have access to the following information:
	Confidential claim information (only select this option if you are a claims coordinator or other type of claims authorized individual)

	Officer/owner information
	Note that the registration process may delayed if we are unable to contact this individual for authorization.
Officer/owner name
Officer/owner title
Phone number
Fax number
Email

	CompOnline terms and conditions
	By registering for CompOnline, you (meaning the policyholder or employer submitting this application) agree to the following terms and conditions: 1. CompOnline is a service provided by SFM Mutual Insurance Company (SFM) to its customers at its sole discretion. SFM is under no obligation to provide access to CompOnline and may limit or terminate your access at any time for any reason. 2. You are responsible for protecting the privacy of your user name(s) and password(s) and for protecting the confidentiality or privacy of any information obtained using CompOnline. You agree to exercise due care to prevent unauthorized employees within your organization and outside third parties from gaining access to CompOnline. SFM has no liability whatsoever for the protection or privacy of your user name(s) and password(s) and shall not be liable for any consequential, incidental or special damages (including, without limitation, loss of business or profits) whether based on breach of contract, breach of warranty, negligence or otherwise, with respect to the privacy of your user name(s) and password(s). 3. The workings of CompOnline represent a trade secret and intellectual property of SFM. You may not disclose information about CompOnline (except for information that is already public), or demonstrate CompOnline, to anyone outside your organization without the written permission of SFM. 4. Much of the information and many of the resources contained within CompOnline are private, confidential and/or proprietary. You acknowledge that your user(s) may have access to sensitive and private medical information about claimants and to other confidential and/or proprietary information within CompOnline, and you agree that such information is not for secondary release or disclosure, which release or disclosure is strictly prohibited. You agree that if any such private, confidential or proprietary information is released or disclosed by you (including your user(s)), you are responsible for any damages claimed to arise out of such release or disclosure by any aggrieved party and/or by SFM. 5. SFM will take reasonable measures to keep third parties from unauthorized access to information submitted by you and to reports requested by you that are contained in or derived from CompOnline; however, SFM does not guarantee that third parties will not have access to any information, comments or materials that you submit to SFM through the SFM website. 6. SFM specifically disclaims any liability with respect to CompOnline and its other Web-based services. SFM shall not be liable for any damages, including, but not limited to, direct, indirect, incidental, special or consequential damages, arising from the use of CompOnline or any of the materials or information contained therein, or arising from any third parties' access to information submitted by you to SFM, or arising from your disclosure of confidential or private information to unauthorized persons. 7. CompOnline is a registered trademark of SFM. The resources contained within CompOnline, and the source code used to produce them, are copyrighted by SFM. These terms and conditions and your use of CompOnline shall be governed in all respects by the laws of the State of Minnesota, except where such law is specifically pre-empted by federal law.
	I accept these terms and conditions

Authorization code
Enter text shown above

CompOnline Registration

Organization information

CompOnline user information

Location information

Access to confidential information

Officer/owner information

CompOnline terms and conditions