Please complete all fields below so we can verify your personal information to set up access to your customer portal.
Please note that we process requests during business hours, Monday through Friday.
Granting access to anyone other than a client:
Because some of your protected health information is visible in the portal, ReproTech will only grant access to a client depositor listed on the account.
To give access to anyone other than a client depositor, we must receive a completed and SIGNED Authorization of Release of Protected Health Information to authorize access.
The completed form must be emailed by the client depositor to firstname.lastname@example.org with a message that portal access be granted to the person named on the authorization.
Already have portal access?
Click to make a payment or access your account information.