Signup

You are welcome to use this Family Med Records program for as long as you like and for free.

When you register below you will have access to the full program. Your information is guaranteed totally private. It will never be released to anyone ever. We need your name, ZIP code (Postal Code) and email address but everything else is optional. If you wish to put in other information it would be helpful in the event you give others your Emergency Page information. Emergency Page information is displayed to those to whom you give your View password (not your main password). You decide what they can see and not see.

When you sign up we will send you a password to access your account. You can change the password to something better when you log on. We need to have a current email address to send reminders that you may request (for example, doctor appointments or prescription reminders).

The only thing we require is that you access the program at least once every 6 months. This way we know the space we reserve for you on our computers is needed. Questions, email us here.

Your first name:
Family (last) Name:
Email address:
ZIP (Postal) Code:
Enter up to 6 Family members' names (if any) next and we will create separate records for them. (If they want to use their own email address for reminders, they should sign up for their own account.)
1 - Firstname:
2 - Firstname:
3 - Firstname:
4 - Firstname:
5 - Firstname:
6 - Firstname:

I have read and agree with terms of use below.*

* This is our disclaimer and statement of non-liability. This is Internet. We are providing a free service to you. These are computers with human-written software that operate on Internet. We cannot assure you that this program will reliably work because these devices can fail at any time. So you agree that if you use this site, you hold us now and forever harmless if the program fails, your expectations are not met or any function of our service seems to fail for any reason be it your fault, ours, or nobodys. If you do not agree, do not use the site.