First, create a Medical Passport account so you can sign in and access or update your information at any time. Once completed you can provide a copy to any healthcare facility you choose.
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- Please enter at least one phone number below.
(never shared, only used for confirmations and support)
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* Username not available
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{{form.Username}}
- Change password
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Add an extra layer of security to your Medical Passport account by enabling two-factor authentication - an optional but highly recommended feature. Once enabled, you will be required to enter a code sent via text message (SMS) to your mobile phone or emailed to you.
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Text Message (SMS) codes will be sent to your mobile phone {{TwoFactorMobilePhone}}
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Text Message (SMS) codes will be sent to your home phone if it is a mobile number {{TwoFactorHomePhone}}
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Email codes will be sent to your email address {{TwoFactorEmail}}
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Terms of Service.
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Your information is never shared with anyone other than your healthcare team. See our Privacy Policy.
Save & Continue
You'll have a chance to update information. Each section must be completed, but you will be able to make changes before you finish.