All fields are required. New Activation Codes can only be obtained at the doctor's office with a valid ID. New codes are NOT give over the phone or via email.
Enter your Activation Code as it appears on your enrollment letter (your code is not case sensitive). You will not need to use this code after you complete the signup process.
Enter your date of birth in the format shown, using 4 digits for the year (If you are the parent or guardian, please enter YOUR date of birth).