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DSH Submissions
Patient Account Data Upload
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User account
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Create new account
(active tab)
Log in
Request new password
Username
*
Spaces are allowed; punctuation is not allowed except for periods, hyphens, apostrophes, and underscores.
E-mail address
*
A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.
Password Requirements
Password must contain at least one alphanumeric (letter or number) character.
Password must contain characters of at least 3 different types (lowercase, uppercase, digit or punctuation).
Password must contain at least one digit.
Password must contain at least one lowercase character.
Password must contain at least one letter.
Password must contain at least one uppercase character.
Password must contain at least one punctuation (not whitespace or an alphanumeric) character.
Password must be at least 10 characters in length.
Password must not contain the username.
Password must not match last 2 passwords.
Provide a password for the new account in both fields.
Password
*
Confirm password
*
Facility Name
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.
What code is in the image?
*
Enter the characters shown in the image.
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