Register for a New Account

Fill out the form below in order to create a new account on this system. Once you've successfully registered, you'll be able to log in to the system immediately. Required questions are marked with (REQUIRED).

Email Address (REQUIRED)

First Name (REQUIRED)

Last Name (REQUIRED)

Telephone Number

Standing (REQUIRED)
-- please select --FreshmanSophomoreJuniorSeniorGraduate StudentStaff

Graduation Year (REQUIRED)
-- please select --201720182019202020212022N/A

What institution are you enrolled at? (REQUIRED)
-- please select --NICU of ILCSCBoise Stateother?

Major (REQUIRED)

Student ID (REQUIRED)

Passwords must be ten or more characters long.

Password (REQUIRED)

Re-Enter Password (REQUIRED)

Email Preferences

Send me an email when my appointments are made, modified or canceled: YesNo

Send me an email with center announcements or other mass mailings: YesNo

Send me an email to remind me of my upcoming appointments: YesNo

Text Messaging Preferences

You have the option of receiving appointment reminders and waiting list "appointment available" notices via text message instead of via email.

In order to enable text messaging, enter your ten-digit mobile phone number and select your carrier below. Once saved, you can test text messaging by returning here and selecting the new "test" link below.

Depending on your mobile carrier and plan, you may incur charges for receiving text messages. By entering your number below, you agreee to be responsible for those charges. In order to opt out of receiving future texts, simply remove your number and carrier below.

Mobile Number

Mobile Carrier:
-- please select --AT&TCingular (GSM)Cingular (TDMA)CricketGoogle FiMetro PCSNextelSpectrum MobileSprint PCST-MobileUS CellularVerizon WirelessVirgin Mobile USXfinity MobileBell MobilityBellFido (Microcell)Koodo MobileManitoba Telecom SystemsNBTelPageNetRogersSasktelTelusVirgin Mobile Canada3 River WirelessAdvantage CommunicationsAirVoiceAllTelBell South (Blackberry)Bell South MobilityBell SouthBluegrass CellularBoost MobileC SpireCallPlusCarolina Mobile CommunicationsCellular One East CoastCellular One PCSCellular One South WestCellular One WestCellular OneCellular SouthCentral Vermont CommunicationsCenturyTelCingular WirelessCook PagingCorr Wireless CommunicationsDobson Communications CorporationDobson-Alex Wireless / Dobson-Cellular OneEdge WirelessGalaxy CorporationGrayLink / Porta-PhoneGTEHouston CellularInland Cellular TelephoneJSM Tele-PageLauttamus CommunicationMCI PhoneMCIMetrocall 2-wayMetrocallMidwest WirelessMobilecom PAMobilfoneMorris WirelessNextelNPI WirelessNtelosOmnipointOnlineBeepPacific BellPageMartPageOne NorthWestPCS OnePioneer / Enid CellularPrice CommunicationsProPagePublic Service CellularQwestRAM PageSafaricomSatelindo GSMSimple FreedomSmart TelecomSouthern LINCSouthwestern BellSprint PagingSunComSurewest CommunicationsTeletouchTelusTIMTritonTSR WirelessUnicelUSA MobilityVerizon PCSVirgin MobileWest Central WirelessWestern WirelessWyndtell

Fake Registration Prevention

In order to help prevent fake or automated registrations on this system, please complete the captcha form below.