Please enter your name and email address below. After pressing the Submit button you will be sent to an online form. This form is six pages long and contains the following two documents:

1. A medical information form
2. A waiver.

Please fill out and electronically sign both of them. If the green “Confirm Signature” box does not pop up when you have completed the forms, it means you have left one of the mandatory fields empty and it needs to be completed before you can continue.

Your confidential medical information will be stored in a secure place. If you'd like more information about the security system we use, you can find it by clicking here.