Register Physician/SleepLab/Clinic

Account Information

Username

The username this user will use to log on to iCodeConnect.
Must only include letters, digits, underscores (_) and dashes (-).
Must be at least 4 characters long.

Password

Must be at least 7 characters long.

Confirm Password

Must match the password entered above.

First Name

Last Name

Organization Name

Email

Receive email notifications

If checked, you will receive email notifications when notes are added for your patients.

User Contact Information

License #

NPI

Address 1

Address 2

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