An official website of the United States government
This page displays the Account Designee information that you have just entered and provides you the opportunity to make changes. Please review it carefully. If you need to change any of the information, click the Edit button next to the corresponding section.
Once you click the Edit button for a section, you will be taken to the appropriate information entry page. Add, change, or delete any information as needed. Once you have entered the correct information, click the Next button to continue to the next page in the Designee Registration page flow.
Click on the Print This Page link to print this page and keep the information for your records.
Once you have reviewed all information on the Designee Summary page and would like to submit the information, click the Next button.
Click the Previous button to return to the previous page.
A federal government website managed and paid for by the U.S. Centers for Medicare and Medicaid Services.
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