Registration

To edit pages on WikiHealthCare, you must have a registered user name and password.

Note: Registered users can change and reset their passwords.

Important: The information provided in this form will be stored in a database on the WikiHealthCare server. Once registered, a User Page will be created for you. By default, only your User ID, Name, Organization and Country will be accessible to other registered users. You may choose to make additional information publicly available (e.g., e-mail address, phone number, web site, title, degree, etc.) by updating your user page.

To register as a new user, simply fill out this form:

	Fields marked * are required
First Name: *
Last Name: *
Wiki Name: * (identifies you to others)
Login Name: * (name you'll use to login)
E-mail address: *
Your password: *
Retype password: *
Organization name: *
Organization URL:
Joint Commission Accredited: *	No Yes
Organizational Context: * (select all that apply)	Academic/University Accrediting Body Ambulatory Care Behavioral Health Care Disease Management Organization Health Care System Home Health Care Hospice Hospital Inpatient Rehabilitation Intermediate Care Laboratory Long Term Care/Nursing Home Professional Association Regulatory Agency Research Insurance Organization Health Plan Employer Other Health Care Purchaser Other Health Care Payer Other
Your Role(s): * (select all that apply)	Addictions Specialist Administrator Case/Care Manager Consultant Chaplain Counselor Dentist Discharge Planner Dietitian Health Care Professional (NOS) Health Information Manager Health Information Specialist Management Engineer Medical Interpreter Nurse Nurse Practitioner Occupational Therapist Pharmacist Physician Physician Assistant Physical Therapist PI/QI Professional Program Coordinator Programmer Psychologist Researcher Respiratory Therapist Risk Manager Scientist Social Worker Statistician Technician Therapist Other
Country: *	Select... USA Canada Albania Algeria Andorra Angola Argentina Armenia Aruba Australia Austria Azerbaijan Bahrain Bangladesh Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Hercegovina Brazil Bulgaria Burundi Cambodia Cameroon Canada Central African Republic Chile China Colombia Congo Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Ecuador Egypt El Salvador Estonia Ethiopia Fiji Finland France Georgia Germany Gibraltar Greece Guam Guatemala Haiti Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakstan Kenya Korea Kuwait Kyrgyz Rebublic Laos Latvia Lebanon Liberia Liechtenstein Lithuania Luxembourg Libya Macao Macedonia Malaysia Malawi Malta Mauritius Mexico Moldova Monaco Morocco Mozambique Namibia Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Romania Russia Saudi Arabia Senegal Singapore Slovakia Slovenia South Africa Spain Sri Lanka Suriname Sweden Switzerland Syria Taiwan Tanzania Thailand Tajikistan Tunisia Turkey Turkmenistan Uganda Ukraine United Arab Emirates United Kingdom Uruguay USA Uzbekistan Vatican City Venezuela Vietnam Yemen Yugoslavia Zaire Zambia Zimbabwe Other Country
Comments: (optional)

I have read and agree to the above Terms of Use. *

Note: When WikiHealthCare receives your registration request, it will e-mail an account activation code to the address you gave above. Enter that activation code in the following screen, or simply click on the link in the e-mail, to activate your account.

• Check your "Junk e-mail box", if you do not receive an e-mail message from the Wiki Administrator within a few minutes of submitting your registration request.

Once your account is activated, WikiHealthCare will:

• Create your personal topic, using your Wiki Name as the topic name, and add the data you submitted to the topic.
• Add your name to the list of other registered users
• Send you a confirmation of your registration by e-mail.

Once registered you can login using your Login Name and password.