Patient Sign Up - External

Patient's Information

Date of Birth

Medical Record Number from greencard


You can find your medical record number in the upper left corner of your RPCCC issued Greencard.

Your medical record number can be found in the upper left corner of your greencard.

Last Four of Social Security Number

This is used for security purposes to make sure you are the patient associated with account being registered.

Success!

Validate

Account Email

Please enter the patient's primary account email address.

This should be the email of the individual who will control access to the account.
Re-enter the email for accuracy.
Submit

Got it!

We've sent an email to the address you provided. A person with access to that email should check for the link to complete the registration.

For technical assistance Monday - Friday, 7 a.m. to 7 p.m., please call our help desk at 1-800-ROSWELL (1-800-767-9355).