My HealtheVet

IDENTIFICATION

Title:	First Name*:	Middle Name:	Last Name*:	Suffix:
Alias:

Social Security Number (*This is required information for VA Patients) First 3 SSN Numbers - Middle 2 SSN Numbers - Last 4 SSN Numbers
Confirm Social Security Number (*This is required information for VA Patients) Confirm First 3 SSN Numbers - Confirm Middle 2 SSN Numbers - Confirm Last 4 SSN Numbers
Gender*:	Birth Date*: Select Birth Month Select Birth Day Select Birth Year
Marital Status	Current Occupation:

You must provide your Social Security Number (SSN) before you can access VA Prescription Refill and future MHV features, such as electronic copies of your VA health information.

VA Patients: In order to access these features, your identity will be verified by matching your MHV account information with your information in the VA system.

Related Links:

RELATIONSHIP TO THE VA

Tell us about yourself. (Check all that apply. *At least one is required.)

VA Patient	Veteran Advocate/Family Member/Friend
Veteran	VA Employee
Health Care Provider	Other

You must indicate that you are a VA Patient before you can access VA Prescription Refill and future MHV features, such as electronic copies of your VA health information.

DONOR INFORMATION

Blood Type:

Organ Donor:

Your Blood Type will appear on your Wallet Card.

PRIMARY ADDRESS

Country*:
Address 1*:
Address 2:
City*:
State: Zip/Postal Code*:
Province (if outside U.S.):

Information entered on this page is for your My HealtheVet account only and is not shared with the VA. If you need to update the information in your official VA record, including the mailing address for your VA prescriptions, please contact the appropriate office at your VA Medical Center.

CONTACT INFORMATION

My Preferred Method of Contact Is*:

Email (E)

Home Phone (H):

Mobile Phone (M):

Work Phone (W):

Fax (F):

Pager (P):

Select your preferred method of contact. Your preferred method of contact will require you to enter information in the corresponding field.

ACCOUNT INFORMATION

User ID and Password

User ID*:
Password*:
Re-enter Password*:

Password Hint Questions and Answers

Question 1*:
Answer 1*:
Question 2*:
Answer 2*:

Your User ID:

must be unique
must contain no spaces
may be a combination of letters and numbers
must be 6 to 12 characters in length
is not case sensitive

Examples Include:

Starfish8
JESmith
1233bc

Your Password Must:

be 8 to 12 characters in length
have at least one letter and one number
have at least one special character (e.g., !, #, %)
have no spaces
be case sensitive
not be the same as the User ID

Examples Include:

#1veteran
some_pass1
giveme$100

Your Password Hint Questions:
A Password Hint is a question you will be asked to confirm your identity. It will be asked if you cannot remember your User ID or Password. Be sure to select questions and answers you will remember.

Terms & Conditions and Privacy Policy

I have read and agree to abide by the following My HealtheVet terms.

*Accept Terms & Conditions
*Accept Privacy Policy

Register with My HealtheVet