An official website of the United States government
The Account Manager Personal Information page provides a way to collect your personal information on the account and to identify you as a CRCP user. The information requested on this page is listed in Table 1. You will be required to enter your personal information in all fields marked with an asterisk (*).
| Field | Format |
|---|---|
| First Name * | Alphabetic -- cannot contain numbers or any special characters but may contain an apostrophe ( ‘ ) or hyphen ( - ). |
| Middle Initial (MI) | Alphabetic. Optional. |
| Last Name * | Alphabetic -- cannot contain numbers or any special characters but may contain an apostrophe ( ‘ ) or hyphen ( - ). |
| E-Mail Address * | Read-only – pre-filled by the system. |
| Phone * + Ext. | Numeric with no spaces -- (includes 3-digit Area Code, 3-digit Exchange, and 4-digit Suffix) plus an Extension (Ext:). Ext. is optional. |
| Address Line 1 * | Must contain at least two characters with 1 number and 1 letter. |
| Address Line 2 | If entered, it must contain at least two characters with 1 number and 1 letter. Optional. |
| City * | Cannot contain numbers or special characters other than spaces, hyphen, apostrophe, colon, or period. |
| State * | Drop-down menu selection. |
| Zip Code * + Zip+4 | Numeric -- cannot contain letters, spaces, or special characters. Zip+4 is optional. |
Once this information is completed, you must read the User Agreement and Privacy Policy provided in the scrolling box. To accept the agreement, click the checkbox. You must accept and agree to the terms of the User Agreement and Privacy Policy to continue with the registration process.
- To view the User Agreement and Privacy Policy, click View and print the User Agreement and Privacy Policy below.
- Select the I accept the User Agreement and Privacy Policy above checkbox to accept the agreement and policy.
- Click Continue to save this information and continue to the next step, or click Cancel to display the Cancel Confirmation page. Click Previous to return to the previous page without loss of data.
From the Cancel Confirmation page, click Cancel to redisplay the Account Manager Personal Information page with all information intact, or click Continue to exit the Account Setup/Account Manager Registration process and return to the Welcome to the CRCP page with no information saved.
January 2025
A federal government website managed and paid for by the U.S. Centers for Medicare and Medicaid Services.
7500 Security Boulevard, Baltimore, MD 21244