All fields are required.
You will need your own activation code to sign up.
Request an activation code
If you are a proxy or you want an activation sent to you, please complete and return one of these forms:
Enter your activation code as it appears on your enrolment letter or After Visit Summary. Your code is not case sensitive.
Enter your date of birth in the format shown, using 4 digits for the year. If you are a proxy signing up to access another patients' record this is your date of birth.