Healthcare Professional (Provider) Registration



















    • Email requirements:

    • First character must be an ascii letter (a-z) or number (0-9)

    • Cannot contain consecutive periods (.)

    • Must contain an at sign (@)

    • Cannot have ` ~ @ before @

    • Following the @ sign must be alphanumeric

    • Must end with a period followed by at least two letters (a-z) for example .com or .org

    • No special character after @ symbol

    • Must have four or more character before @









    • Username requirements:

    • Use between 6 and 25 characters

    • Username cannot include spaces or special characters (&, %, *, etc.)



    • Password requirements:

    • Must be at least 8 characters

    • Must contain 1 number

    • Must contain 1 uppercase letter

    • Must contain 1 lowercase letter

    • Cannot contain part of username

    • Only the following special characters are allowed: ” ! # $ % & ' ’ ( ) * + , - . / : ; < = > ? @ [ ] ^ _ ` { | } ~




    • Security Answer requirements:

    • Must be at least 4 characters

    • Cannot contain part of the security question

    • Cannot contain part of email address

    • Cannot be same as password

    • Cannot be same as username



  1. I have read and I agree to the Online Services Terms of Use as outlined above.

  2. Change the CAPTCHA codeSpeak the CAPTCHA code