service provider details
Register as a Service Provider
Service provider's number
Service provider's name
Country
Policy holder's DoB
Service provider's email address
Password must:
• Be a minimum of 8 characters
• Contain at least one uppercase letter ('A' - 'Z')
• Contain at least one symbol ('!', '*', '#', '_', etc)
• Not contain sequential letters and numbers ('abc', '123')
New password
Confirm new password