Welcome ReproTech Patients!
Please enter the requested information to create your account
Choose Clinic
State CLINIC is located in
Enter Portal Account User. This may be the patient or parent of a minor. Patient/Partner information will be entered on future screens, this is for portal access only.
Please enter your legal name as on your ID as this will be used for ID verification matches.
*First Name
Middle Name or Preferred Name
*Last Name
*Email
*DOB
Enter Password
*Password
*Confirm Password
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