Please Identify Yourself

Step 1

All fields are required.
*Please contact myBeaumontChart Support at 248-597-2727 if you have Date of Birth or Zip Code errors*

myBeaumontChart Activation Code

Enter your Activation 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
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xxxxx
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xxxxx
Date of Birth

Enter your date of birth in the format shown, using 4 digits for the year.

mm
/
dd
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yyyy

Please enter your ZIP code.

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