Register for a New Account

Fill out the form below in order to create a new account on this system. Fields marked with * are required.

First Name *

Last Name *

Name Pronunciation

Email Address *

Telephone Number

Standing *

Graduation Year *

What institution are you enrolled at? *

Major *

Student ID *

Password

Passwords must be ten or more characters long.

Password *

Re-enter Password *

Communication & System Preferences

Email Options

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

Send me an email with center announcements or other mass mailings.

Send me an email to remind me of my upcoming appointments.

Include iCal links with appointment confirmation messages.

System Preferences

Open appointments in a new popup window (instead of in a modal within the same browser tab).

Text Messaging Options

You have the option of receiving appointment reminders and waiting list 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. Depending on your mobile carrier and plan, you may incur charges for receiving text messages. You agree 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

Fake Registration Prevention

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

Cancel