'How to Register Successfully' Instructions

Please read this page first before starting the process. It contains all information needed to successfully register

Once you submit the patient application you will not be able to return to change the information you provided. You may add any additional documents after submission.

Items Required:

(Please note all documents must be scanned either onto a disk or a computer and cannot exceed the size of 2MB) We do not accept mailed copies of documents. Documents cannot be uploaded through any mobile device including cell phones and tablets.

 - The REFERENCE number that was provided to you by your registered physician (this number may be found on your copy of the attending physician statement) What is this?
 - An email address (Customer Service provides all patients up to date with information through email).
 - Scanned Documents
    • Passport style photograph of you against a white solid background such as a wall. No glasses or hat are permissible.This photograph will be used for your identification card.
    • Government issued photo ID
    • Proof of New Jersey Residency: utility bill, tax bill, credit card bill, bank statement, or any document issued from the IRS
    • Proof of Government Assistance-if applicable: Click here
      • The registration fee for your identification card will be $200. If you are eligible for the accepted government assistance programs, the identification card will be $20. Please note, once payment is made, there are no refunds per regulations.

If you chose to sign up a caregiver please be aware a caregiver must get a criminal background check through fingerprints. There is a form on the bottom of the page where you upload your documents to print. On this form, it will have the information needed on how to make an appointment for fingerprints. Registration fees will not be set to your account until your caregiver's criminal background check is cleared. Also, a caregiver will have to pay a registration fee as well as the patient for their identification card.