Please Identify Yourself

All fields are required.

MyCHOP Access Code

Enter your Access Code as it appears on your enrollment letter (your code is not case sensitive). You will not need to use this code after you complete the signup process.

xxxxx
-
xxxxx
-
xxxxx
Date of birth

Enter YOUR date of birth (not your child's) in the format shown, using 4 digits for the year.

mm
/
dd
/
yyyy

Please enter your ZIP code.

xxxxx