1. Patient/caregiver log in credentials. If you have not created your user account, you will need both the reference ID number and registry ID number located on your healthcare practitioner’s statement.
2. Valid ID with current address, or two proofs of residency: (may be any two of the following)
   
   • State/Federal Document 
   • Utility bill or phone bill (within the last 90 days) 
   • Bank Statements, Paystubs (past 3 statements) 
   • An official Deed 
   • W-2, 1099 statement, Form 1098 or any other correspondence from the IRS (The program does not accept a 1040 form or 1095 form.)

New enrollees need prior authorization from a registered healthcare provider in the MCP program.  Don't have one? Find one here. 

 All new and renewing patients and caregivers will have their photos taken during the registration clinic for their IDs. If you opt for a physical card, payment can only be made with a credit or debit card.

1. Patient/caregiver log in credentials
2. Valid ID with current address, or two proofs of residency: (may be any two of the following)
   
   • State/Federal Document 
   • Utility bill or phone bill (within the last 90 days) 
   • Bank Statements, Paystubs (past 3 statements) 
   • An official Deed 
   • W-2, 1099 statement, Form 1098 or any other correspondence from the IRS (The program does not accept a 1040 form or 1095 form.)

 All new and renewing patients and caregivers will have their photos taken during the registration clinic for their IDs. If you opt for a physical card, payment can only be made with a credit or debit card.

1. Access to email 
2. Reference ID Number (Located on your Healthcare Practitioners Statement) 
3. Registry ID Number (Located on your Healthcare Practitioners Statement) 

1. Patient/caregiver log in credentials      
2. Valid ID with current address, or two proofs of residency: (may be any two of the following)
   
   • State/Federal Document 
   • Utility bill or phone bill (within the last 90 days) 
   • Bank Statements, Paystubs (past 3 statements) 
   • An official Deed 
   • W-2, 1099 statement, Form 1098 or any other correspondence from the IRS 

 All new and renewing patients and caregivers will have their photos taken during the registration clinic for their IDs. If you opt for a physical card, payment can only be made with a credit or debit card.

1. The caregiver’s Government issued ID that reflects their current physical address, or two proofs of residency from different entities: (may be any two of the following)
   
   • State/Federal Document 
   • Utility bill or phone bill (within the last 90 days) 
   • Bank Statements, Paystubs (past 3 statements) 
   • An official Deed 
   • W-2, 1099 statement, Form 1098 or any other correspondence from the IRS (The program does not accept a 1040 form or 1095 form.)
2. Caregiver's registry ID Number (Located on your Healthcare Practitioners Statement) 
3. Caregiver's reference ID Number (Located on your Healthcare Practitioners Statement) 

 All new and renewing patients and caregivers will have their photos taken during the registration clinic for their IDs. If you opt for a physical card, payment can only be made with a credit or debit card.

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