Data iSight - Patient

Registration

First Name	Enter a first name
Last Name	Enter a last name
Insurance Carrier	Enter your insurance provider
Policy Number	Enter a company name
Phone	Enter a number like 111-222-3333
Address 1	Enter an address
Address 2
City	Enter a city name.
State	Select a state
Zip	Enter a zip
Email Address:	Enter an Email
Password:
Confirm Password: