Registration Form

Step One

Click here to read Terms and Conditions of Use Form

Step Two

Click here to read Privacy and Security Commitment Form

Step Three

Please enter the information in the fields below. Please note: You must be a provider or care team member with a treating relationship, or have had previous approval by the HIM department for access, in order to request a login to billingsclinicconnect.com. All applications are subject to approval. All fields are required to be approved for a login.