My Premise Health

To create a My Premise Health account, please complete the required fields below. You must have a record inside of our system to be eligible for a My Premise Health Account. If approved, you will be able to create your My Premise Health username and password immediately. If we do not have a record in our system, please contact your onsite health center team.

If you have any questions, please contact My Premise Health Support.

To sign up for a My Premise Health account you must have a profile in our system. Enter your demographics below, and you will be directed to verify your identity using questions from a third-party verification system. If successful, you will be directed to create a username and password.

If you have any questions or have trouble signing up, please contact My Premise Health Support.

First name

Middle name

Last name

Date of birth

Legal Sex
Your legal sex is what is listed on your ID. This includes passports, driver's licenses, green cards, and other forms of official identification.

Female Male Unknown

Last four digits of SSN

Email address

Verify email address

Home phone

Mobile phone

I understand that by clicking on the NEXT button immediately following this notice, I agree that I have read this notice, and I am providing "written instructions" to Premise Health under the Fair Credit Reporting Act authorizing Premise Health to obtain information from my personal credit profile or other information from Experian (identity verification software). I authorize Premise Health to obtain such information solely to confirm my identity prior to activation of a My Premise Health account in my name.

The questions on the following page are from a third-party system. Questions from your credit profile will be used to confirm your identity. This process will NOT affect your credit rating.

If you do not wish to continue, please contact My Premise Health Support or your health center to assist with your account creation.

Sign Up

Name

Address

Other information

Sign Up

Patient information

Name

Address

Other information

Unable to Verify Your Identity

Unable to Verify Your Identity