Please enter your desired User Name up to 10 digits and characters in length. Do NOT use special characters, punctuation symbols, etc. If your requested user name is already in use, you will be prompted to choose a different one. Click the Submit button at the bottom of this page when you have completed this form.

New User Name  
New Password
Confirm Password   
First Name
Last Name
E-mail Address*
Phone*
Residency

* = optional

On the next page, you will be asked to select the faculty member from the residency program you select here.

 




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San Diego Immunization Branch (SDIB)
County of San Diego, HHSA
3851 Rosecrans Street, Suite 704
San Diego, CA 92110

phone  866.358.2966