Doctor Registration

Welcome to MySecurePractice

Please complete the following form to create an account
for MySecurePractice.

You will receive another email after submitting the form
to finalize the creation of your account.

Practice Information

Please provide your location and contact information.

Create a User for your Account

Fill out the information for your login account.

(This will be your MySecurePractice login)

Choose Your Specialties

Select your specialty from the list below.

Choose Your Procedures

Click on the "Show All" button to view all of the available procedures. Click on a procedure to add/or remove it from your list of services.

We have auto-selected procedures based on your selected specialty.

Choose Your Security Preferences

Please choose the security settings for your doctors and patients.