Step 1
All fields are required.
Enter your Activation Code as it appears on your enrollment letter (your code is not case sensitive). You will not need to use this code after you complete the signup process.
Please enter the last 4 digits of your Social Security Number. If you receive an error and can not sign up, please contact your doctor's office to confirm that our records match your information.
Enter your date of birth in the format shown, using 4 digits for the year.
