New Registration

In order to register you will need the registration code assigned to you. If you are eligible a letter was sent to you via the United States Postal Service ®.



Invalid Registration Code
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Invalid Registration Code


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Required Invalid Evidence Number

By entering the information requested above and by continuing this registration process, you certify that you are the named addressee of the letter which provided you with the registration code you entered on the previous page or a person legally authorized to act on behalf of the name addressee. Information contained in this website is confidential and may be subject to protection under the law, including the Health Insurance Portability and Accountability Act (HIPAA). If you are not the named addressee or authorized to act on behalf of this person, you are hereby notified that any further use of this website is strictly prohibited and may subject you to criminal or civil penalties.