Create a New Account

Use the form below to create a new account.

New passwords requirements are as follows:

  • Password must be at least 8 characters and 15 characters for Privilleged users
  • Password must be different from last 10 passwords used and 24 passwords for Privilleged users

    • Password must contain characters from 3 of following 4 categories:
  • Uppercase characters [A-Z]
  • Lowercase Characters [a-z]
  • Arabic Numerals [0-9]
  • Non Alphanumeric Characters [!$#,%]

    • To have a medical facility added to the customer list, please call 517-335-1400.

    Account Information