All fields are required.
Enter the activation code you received on your After Visit Summary, on a bill or at your provider’s office. If you received your activation code via email it will automatically be added into the fields below.
If you received a six-digit authentication code via email, you will need to enter this on the Security Verification screen. You cannot enter your security authentication here.
Enter your date of birth in the format shown, using 4 digits for the year.