User Registration - My HealtheVet

Register with My HealtheVet

Create your My HealtheVet user profile.

* Indicates Required Information

IDENTIFICATION

This form must be completed to get a My HealtheVet account. To register, you are required to enter identification (ID) information exactly as it appears on your primary ID card issued by a federal, state, or local government agency. Fields with an asterisk (*) are mandatory and must be completed before you submit your registration form. You are required to provide your Social Security Number (SSN). Be sure to accept the Terms and Conditions and the Privacy Policy. Contact the Help Desk for assistance.

Title:

First Name*:

Middle Name:

Last Name*:

Suffix:

Alias:

Social Security Number*:

Confirm Social Security Number*:

Gender*:

Birth Date*:

Marital Status:

Current Occupation:

RELATIONSHIP TO THE VA

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

DONOR INFORMATION

Your Blood Type will appear on your Wallet Card.

Blood Type:

Organ Donor:

PRIMARY ADDRESS

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.

Country*:

Address 1*:

Address 2:

City*:

State:

Zip/Postal Code*:

Province(if outside U.S.):

CONTACT INFORMATION

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

My Preferred Method of Contact Is*:

Email (E):

Confirm Email (E):

Home Phone (H):

Mobile Phone (M):

Work Phone (W):

Fax (F):

Pager (P):

SUBSCRIBE TO EMAIL NOTIFICATIONS AND REMINDERS

Select your preference to start or stop email notifications and reminders for the following features. By default these reminders are turned off. If you want to receive reminders or notifications, select the Turn On radio button.

Rx Refill Shipment Notification

Turn On

Turn Off

VA Appointment Reminder

Turn On

Turn Off

ACCOUNT INFORMATION

User ID and Password

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 and 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 and not be the same as the User ID
Examples Include: #1veteran, some_pass1, giveme$100

User ID*:

Password*:

Re-enter Password*:

Password Hint Questions and Answers

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.

You must select two different questions. A different answer is required for each question.

Question 1*:

Answer 1*:

Question 2*:

Answer 2*:

Terms & Conditions and Privacy Policy

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

	Accept*	My HealtheVet Terms & Conditions
	Accept*	Privacy Policy

Secure Messaging is a way for you to securely communicate online with staff at your VA facility. To use this feature, please accept the Secure Messaging Terms and Conditions.

Secure Messaging Terms & Conditions

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