Signing up for your account is easy,
just complete the following
three
steps:
Step 1
— Verify your identity by providing the information below.
First Name:
Last Name:
Birthdate (mm/dd/yyyy):
Email Address:
Last 4 Digits of your SSN:
Why is this needed?
To protect the privacy and security of your health information, the last 4 digits of your SSN are required in order to verify your identity with your healthcare provider(s). If you choose not to provide the last 4 digits of your SSN you will not be able to register online. Please contact your healthcare provider directly to register.
Step 2
— Choose a Username, Password, and read the Terms and Conditions.
Username:
Password:
Confirm password:
I have read the
Privacy Statement
and agree to the
Service Agreement
.
Step 3
— Click "Create Account" and you're done.
Create Account
Cancel Setup
