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Please Identify Yourself

Step 1 of 3 All fields are required.



MyCHOP Access Code
xxxxx
-
xxxxx
-
xxxxx
 

ENTER YOUR MyCHOP ACCESS CODE EXACTLY AS IT APPEARS ON YOUR ENROLLMENT LETTER. You will not need to use this code after you've completed the signup process.

Date of Birth
mm
/
dd
/
yyyy

Enter YOUR date of birth (not your child's) in the format shown, using 4 digits for the year.

xxxxx

Please enter your ZIP code.

No Access Code? Please contact your healthcare provider.