If you have difficulty registering, please email us at firstname.lastname@example.org for assistance.
Enter your full name
Enter your work phone number
Enter your email address
If you were given verification codes from SIHCA, enter them in the two fields below.
Verification code 1
Verification code 2
If you were NOT given verification codes, enter your NPI and Tax ID below.
Enter the NPI of the provider where you work
Enter the Tax ID of the provider where you work(numbers only, no dashes)
Select your first security question
Enter the answer to your first security question
Select your second security question
Enter the answer to your second security question
Select your third security question
Enter the answer to your third security question