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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="/MyChartPRD/" title="My Health"></a><div class="title"><h1 class="header">Use Activation Code</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="/MyChartPRD/accesscheck.asp" id="accessForm"csp-guid-submit="22EC9C2192104F8DAB973883482B008B"><div class="formcontents"><div class="hidden"><input type="hidden" class="hidden" name="accessformtoken" value="17CB4D16F0164293AC8B2E1F29418BAA" /></div><script nonce='0463CD8A22894A699C96B5CCE21A5615' 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">My Health 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="5EC2F7FFE2C54650BA70E1B181161FEF" csp-guid-keyup="A883C9626E68426A9891636AD4CA55D3" csp-guid-keydown="5AA33E0898F843D98A616FC774FC02B2" csp-guid-click="799FBF75FC3A405288AF3F1CCCE37AC2" csp-guid-keypress="49314B6E6E604C63BAE2BFDE283BFD8D" /><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="7CFCB4B77280450DB27AA21FD08BD000" csp-guid-keyup="23CB1EBC1DC345F4A4748B0D7520F1FD" csp-guid-keydown="258E59142CDA4CA3B34CE0C0DE0D187F" csp-guid-click="6FA65A1186EA4A2BA37AB034739A2119" csp-guid-keypress="49314B6E6E604C63BAE2BFDE283BFD8D" /><div class="helptext accessibleLabel">xxxxx</div></div><div id="codeerror" class="alert signUpFieldError"></div></fieldset><script nonce='0463CD8A22894A699C96B5CCE21A5615' 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="9FD78E05611747189AA1F04351775959" csp-guid-keydown="B8959F92799B447BB394E8ACE5F53291" csp-guid-blur="DB2FC52F89F44831BEA7DA8B504E6A2D" csp-guid-click="4D57FFAC2241421989EEC526EFB8152F" csp-guid-keypress="D1F23BBE925E4D05B13A57D4EB7083EA" /><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="A71922B4C22E4648AB4A031F7139A2E9" csp-guid-keydown="E185EEA4CC774FAC98ADFA2DA9B9B2A9" csp-guid-blur="72283DFCE12D409A949E68684956EFE1" csp-guid-click="3C1D4418737D45A4A5ECC867B5C85D47" csp-guid-keypress="3F7A65348E8541AB99D56A1EFD904A4B" /><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="5BA42CAB199F479188A652142D7F75F7" csp-guid-keydown="5BAF2B94F3964359AAA5280927491DB9" csp-guid-blur="24A33AE155E24F79A44E565A8744DD39" csp-guid-click="16C927C4732E43F9A813B69C8EA5DCF6" csp-guid-keypress="203C3A904CC2432BB23D641EC5ACAF53" /><div class="helptext accessibleLabel">yyyy</div></div><div id="doberror" 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='0463CD8A22894A699C96B5CCE21A5615' 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="41F136FB509A486D8329B4B1EEB16E37" csp-guid-blur="5CD7472ACE8246828654EF07F2121D2A" /><div class="helptext accessibleLabel">xxxxx</div></div><div id="ziperror" class="alert signUpFieldError"></div></div><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="/MyChartPRD/accesscheck.asp?lang=espanol" csp-guid-click="D85ACB31835A41F6872FB671F0807061"><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="/MyChartPRD/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 id="SelfSignupButton" href="./Signup" class="button otherbutton">Sign up online</a></div></div></aside><footer id="footer"><div id="mainFooter" class="mainStyle"></div><div id="sidebarFooter" class="sidebarStyle"><div id="mychart_by_epic_logo_wrapper"><img id="mychart_by_epic_logo" src="/MyChartPRD/en-US/images/MyChartByEpic_inline_dark.svg" alt="" /></div><span class="copyright" lang="en"><a href="/MyChartPRD/Authentication/Login?mode=stdfile&option=epiccopyright" csp-guid-click="ECE8BE61CDAA4BE1AAD44EBB47232E1B"><span class="copystring">MyChart® licensed from Epic Systems 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