1. Please enter your personal information, including a valid email address. Be sure to enter your name, exactly as it appears on your prescription label.
2. Please enter your birth date by selecting the appropriate day, month and year.
3. Please select a password, and enter it twice to confirm. All passwords must be at least 6 characters long and include at least one number, and one letter.
4. Please enter the Profile Access Code provided by your pharmacist.
5. Once the form is complete, please click "Sign Up" and your profile will be verified. Please note that this may take up to 1 minute. Your patience is appreciated.