Reliance Rx Portal > Account Registration

ACCOUNT VALIDATION

Patient Registration

Create an Account

If you already use Patient Digital to get your supplies with your pharmacy benefit, you can create an account by filling out the fields on this page. Visit PatientDigital.com to learn more about the difference between using pharmacy vs medical benefits for your health care supplies.

Note: Your email address will be set as your user id when logging in. The password cannot be the same or contain your user id.

Password Requirements:
- At least 8 characters
- At least one uppercase letter
- At least one lowercase letter
- At least one number
- At least one special character (#,$,%,etc.)

*Note: Membership to this site is public. Once your account information has been submitted, you will be granted immediate access to the site. All fields marked with a red asterisk are required. (Note: - Registration may take several seconds. Once you click the Register button please wait until the system responds.)

First Name:

Enter a first name.

Last Name:

Enter a last name.

Email Address:

Enter a valid email address.

Password:

Enter your password.

Confirm Password:

Re-enter the password to confirm.

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