First Time Users

Please enter your information below. Please allow 2 business days to receive confirmation of your registration via email.

Are you a Canopy client? If you do not have your username and password, please contact your project team leader instead of filling out the form below.

* indicates required fields
Name:*
Organization:*
(Please fill in your full organization name without abbreviations)
Client Number:
Title:
Phone:*
Fax:
Email:*
Requested Username:*
(Usernames may not contain spaces
Please be creative when choosing your username as we cannot allow duplicate usernames)
Password:*
(Password must be 6-12 characters)
Verify Password:*
YES! I would like to receive A4 Health Systems' News & Updates by email