smcprimprod > Account Registration

Patient Registration

To Register

It takes only a moment to register for the Specialty Pharmacy Patient Portal. Please fill in the needed information.

Note: Your email address will be set as your user id when logging in. The password cannot be the same or contain your user id.

Password Requirements:
- At least 8 characters
- At least one uppercase letter
- At least one lowercase letter
- At least one number
- At least one special character (#,$,%,etc.)

*Note: Membership to this site is public. Once your account information has been submitted, you will be granted immediate access to the site. All fields marked with a red asterisk are required. (Note: - Registration may take several seconds. Once you click the Register button please wait until the system responds.)

First Name:

Enter a first name.

Last Name:

Enter a last name.

Email Address:

Enter a valid email address.

Password:

Enter your password.

Confirm Password:

Re-enter the password to confirm.