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If you require assistance during this process, call the helpdesk at 1-800-218-2205.
Tell us about yourself:
First Name 
Last Name 
Birthdate (mm/dd/yyyy) 
E-mail Address 
Phone (xxx-xxx-xxxx) 
Fax Phone (xxx-xxx-xxxx) 
Client 

Create your account identifiers:  (For help, see instructions below)
User Name 
Password 
Password: Weak
Re-type Password 
Secret Question 
Answer to Secret Question 
  Required Information.
     

Detailed Instructions:

User Name:  This must be unique. If your first choice is not unique, you will be prompted to choose again. Use a combination of upper and lowercase alphabetic (A-Z, a-z) and numeric (0-9) characters.

Password:  To create a "strong" password, we recommend a combination of at least 8 uppercase and lowercase alphabetic (A-Z, a-z) characters along with numeric (0-9) characters and at least one special symbol. If we feel your password is too "weak", you will be prompted to create another one. Note that the following special symbols are not permitted in passwords:

< > ' "
% ; ( )
& + -

Secret Question:  Create a question to which only you know the answer.

Answer to Secret Question: If we need to verify your identity, we will ask you the secret question. You must be able to supply the answer.

Version 07.03.26