Identity Self Service

User Verification

*Enter the code above

Basic Information

*First Name

Middle Name

*Last Name

*E-mail

*Confirm E-mail

Display Name

An email address is required to apply online at Vermont Health Connect. If you not do have an
email address, you can create one for free online. If you would rather apply over the phone or
need more help, please call our customer support center: 1 (855) 899 9600.

Enter User Id and Password

*User Login

Emails cannot be used as usernames

*Password

*Confirm Password

Please choose a password that meets the following requirements:
  - Starts with an alphabetic character
  - Includes a least 2 alphabetic character(s), including 1 lowercase and 1 uppercase letter
  - Is at least 8 character(s) long
  - Includes at least 1 number
Please do not include your first name, last name or user ID in your password

Select your challenge questions and answers

The challenge questions and answers are used if you forget your password and need to reset it.

*Question 1

*Answer 1

*Question 2

*Answer 2

*Question 3

*Answer 3

User Registration

User Verification

Basic Information

Enter User Id and Password

Select your challenge questions and answers