Please enter your name and email address below. After pressing the Submit button you will be given access to an online form. This form is 6-pages long and contains the following two documents:
1. A medical information form
2. A waiver
Please fill out and electronically sign both of them. It will take less than 5 minutes. If the green “Confirm Signature” box does not pop up when you have completed the forms, it means you have left one of the fields empty that needs to be completed before you can continue.
Your confidential medical information will be stored in a secure place. If you’d like more information about the security system we use, you can find it here.