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Screen readers: use read next line command to hear instructions."), "Global"); </script> </head> <body class="accessPage hasNoCommunityLinks isPrelogin color1 graphicHeader md_default"> <div id="classicPopupRoot" class="overlayContainer"><div id="onboarding-content" class="jqHidden"></div></div><div id="wrap" class="withSidebar" data-hide-during-popup="true"><header id="header" class="prelogin"></header><div id="content" class="hasSidebar"><main id="main"><a class="logo" href="/ucsfmychart/" title="UCSF MyChart"></a><div class="title"><h1 class="header">Please Identify Yourself</h1></div><div id="accessErrorMessage" class="alertHeader"></div><p class="pretext"></p><p class="pretext">All fields are required.</p><form autocomplete="off" method="post" action="/ucsfmychart/accesscheck.asp" id="accessForm"csp-guid-submit="874B8049EA0842A3B32026C2A2728D2B"><div class="formcontents"><div class="hidden"><input type="hidden" class="hidden" name="accessformtoken" value="866C918BA55C40469536A99C2C9A42B9" /></div><script nonce='20831B75A8DB4B5991479F05A11FCC43' type="text/javascript">var sEmptyFieldErrorAccess = HTMLUnencode("<span class="clearlabel">Error: </span>Please enter your activation code."), sInvalidFieldErrorAccess = HTMLUnencode("<span class="clearlabel">Error: </span>Invalid activation code.");</script><fieldset class="formsection legacyLabelledField"><legend class="fieldGroupPrompt required">UCSF MyChart activation code</legend><p class="helptext">Enter your activation code as it appears on your enrollment letter or After Visit Summary庐. Your code is not case sensitive.</p><label class="clearlabel inlinelabel" for="code1">Activation Code Part 1</label><div class="segment5"><input disabled="disabled" class="disabledfield jsreq" type="text" name="code" id="code1" maxlength="5" value="" csp-guid-blur="FBB5130AB7D042BA9C107909DF524B19" csp-guid-keyup="B54C9B8D2FDC4E4BA6EFA28ADEB37B3F" csp-guid-keydown="753E1FF2DC8E418E8F55704EBE62E219" csp-guid-click="9EFC6D0894AC4D87AC0147CADCA914A0" csp-guid-keypress="57497732CB8E43549150C906A20E64E1" /><div class="helptext accessibleLabel">xxxxx</div></div><span class="separator">-</span><label class="clearlabel inlinelabel" for="code2">Activation Code Part 2</label><div class="segment5"><input disabled="disabled" class="disabledfield jsreq" type="text" name="code" id="code2" maxlength="5" value="" csp-guid-blur="09555DEC5432444297B705C27B53C937" csp-guid-keyup="9505B8F159D3414AAF452C4D793587EC" csp-guid-keydown="2AF4F7C13E2F403E9864B1A6D895522A" csp-guid-click="9F26F69049404557BCD3E0BE5AB1921B" csp-guid-keypress="57497732CB8E43549150C906A20E64E1" /><div class="helptext accessibleLabel">xxxxx</div></div><span class="separator">-</span><label class="clearlabel inlinelabel" for="code3">Activation Code Part 3</label><div class="segment5"><input disabled="disabled" class="disabledfield jsreq" type="text" name="code" id="code3" maxlength="5" value="" csp-guid-blur="10A6248F857748B4AB514D2BE613FE36" csp-guid-keyup="33A397DBBC4F429F94CF50FDE531D2C7" csp-guid-keydown="1AF32A3CDBAC4D49AE5CF4094F57F62F" csp-guid-click="B7973DFB1FC748BBAD4CCFEDB9DCA2B3" csp-guid-keypress="57497732CB8E43549150C906A20E64E1" /><div class="helptext accessibleLabel">xxxxx</div></div><div id="codeerror" class="alert signUpFieldError"></div></fieldset><div class="formsection legacyLabelledField"><label for="zip" class="fieldGroupPrompt required">ZIP code</label><p class="helptext">Please enter your ZIP code.</p><script nonce='20831B75A8DB4B5991479F05A11FCC43' type="text/javascript">var sEmptyFieldErrorzip = HTMLUnencode("<span class="clearlabel">Error: </span>Please enter your ZIP code.");var sInvalidFieldErrorzip = HTMLUnencode("<span class="clearlabel">Error: </span>Invalid ZIP code.");</script><div class="segment5"><input disabled="disabled" class="disabledfield jsreq" type="text" name="zip" id="zip" value="" maxlength="10" csp-guid-keyup="87B93CC20AC54819B020DDDC79608DBC" csp-guid-blur="E2FD5F752AEB472FA8AC32100ED15F1D" /><div class="helptext accessibleLabel">xxxxx</div></div><div id="ziperror" class="alert signUpFieldError"></div></div><script nonce='20831B75A8DB4B5991479F05A11FCC43' type="text/javascript">var sEmptyFieldErrorDOB = HTMLUnencode("<span class="clearlabel">Error: </span>Please enter your date of birth."), sInvalidFieldErrorDOB = HTMLUnencode("<span class="clearlabel">Error: </span>Invalid date of birth.");</script><fieldset class="formsection legacyLabelledField"><legend class="fieldGroupPrompt required">Date of birth</legend><p class="helptext">Enter your date of birth in the format shown, using 4 digits for the year.</p><label class="clearlabel inlinelabel" for="dob1">Month of birth</label><div class="segment2"><input disabled="disabled" class="disabledfield jsreq" type="text" name="dob" id="dob1" maxlength="2" value="" csp-guid-keyup="4B124FD3D26242ED8E78525FAAC15C2E" csp-guid-keydown="F6536CD7DD0B4A5AA94206E21D8E95D4" csp-guid-blur="A4E1572E8AE6481995B5766A18EBC71E" csp-guid-click="C83E6EB2919A46AB831FFF69ED899AB2" csp-guid-keypress="5FA9EFEFA7514F96B9CE4B87865C50A0" /><div class="helptext accessibleLabel">mm</div></div><span class="separator subtle">/</span><label class="clearlabel inlinelabel" for="dob2">Day of birth</label><div class="segment2"><input disabled="disabled" class="disabledfield jsreq" type="text" name="dob" id="dob2" maxlength="2" value="" csp-guid-keyup="84B90B44B7984A21961EF8BEF4D9E862" csp-guid-keydown="A7BF0D0B61D0417EB8F8B8BDE9C23FAA" csp-guid-blur="E5ACC1B40B1949EB8EFB7C9C310C2693" csp-guid-click="1BC86960137B44AC935003218E605839" csp-guid-keypress="63C80AF9DE09401192958C8F66ACAAED" /><div class="helptext accessibleLabel">dd</div></div><span class="separator subtle">/</span><label class="clearlabel inlinelabel" for="dob3">Year of birth</label><div class="segment4"><input disabled="disabled" class="disabledfield jsreq" type="text" name="dob" id="dob3" maxlength="4" value="" csp-guid-keyup="7B748D00E3F54974BA235B5BFD5F639E" csp-guid-keydown="46C4C2BB8938432E919B58A3E33BBDA3" csp-guid-blur="FF8270F8FB9A4179A567A571E1E530B1" csp-guid-click="3788F522890847E784D36BFEA7DC3C40" csp-guid-keypress="C510F506F4BD47B28572A93ADBA9358E" /><div class="helptext accessibleLabel">yyyy</div></div><div id="doberror" class="alert signUpFieldError"></div></fieldset><div class="formsection formbuttons"><input class="hidden" type="hidden" id="jsenabled" name="jsenabled" value="0" /><input class="hidden" type="hidden" name="nfrmhypsp" value="1" /><input class="hidden" type="hidden" name="access" value="Next" /> <input class="button disabled jsreq nextstep" type="submit" name="access" id="access" value="Next" title="" disabled="disabled"/></div> </div></form></main><aside id="sidebar"><div id="locale_container" class="prelogin"><a href="/ucsfmychart/accesscheck.asp?lang=espanol" csp-guid-click="A1B90F4CACAF44DAB3CF25DB1D982FE0"><span class="localename">Ver en espa帽ol</span><abbr class="abbreviatedname" title="Ver en espa帽ol">Esp</abbr></a></div><div class="loginAlerts"><div class="hidden errorMessage" id="loginErrorMessage"></div><div id="nojavascript"><span class="alert"><img src="/ucsfmychart/en-US/Images/warning.png" alt="" /> <span class="clearlabel">Error: </span>You must enable JavaScript to use this site.</span><span><a target="_blank" href="Help/JavaScript">Click here for instructions on enabling JavaScript.</a></span></div></div><div class="posttext"><div id="SelfSignupDiv"><h2>No Activation Code?</h2><a 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