Please Identify Yourself

Step 1 of 3

All fields are required.

Enter your activation code as it appears on your activation letter or in the after visit summary from your provider’s office (your code is not case sensitive). You will not need to use this code after you complete the signup process.

Date of Birth

Enter your date of birth in the format shown, using 4 digits for the year.


Please enter the ZIP code of where you lived the last time you registered in the Clinic.