All fields are required.
Enter your activation code as it appears on your enrollment letter or After Visit Summary®. Your code is not case sensitive.
Enter your Unit History Number (UH#) or Medical Record Number (MRN), starting with first number and ending with the letter (e.g. 123456A). The numbers may be found on a After Visit Summary or billing statement.
Enter your date of birth in the format shown, using 4 digits for the year.