New online membership is only
$39.95 for the first three months!

Join the growing community of Track Your Plaque members who are serious about preventing and reversing heart disease!  Your membership will be automatically renewed quarterly at the reduced rate of only $19.95 to keep you connected to the most powerful heart disease prevention program available today.  Members can cancel at any time.

Complete the form below then click the "Submit" button to register online.  To comply with HIPAA requirements for medical privacy, all personal identifying and financial information is sent via secure, encrypted transmission and stored offline, virtually eliminating the potential for online theft or tampering.  This prevents us from electronically activating your membership, however, all applications are processed within 24 hours of receipt.

You may also register via fax or regular mail. Simply forward the information requested below along with payment using the contact information found on the Contact Us page.
Step 1: Select a User Name, Password, and Membership Type

Enter a User Name and Password.    User Names and passwords may be up to 16 characters in length and must consist of lowercase letters a-z and digits 0-9 with no spaces to ensure compatibility with all Track Your Plaque Expert databases.
 
Email Address:
Username:
Password:
Confirm Password:
Membership Type:
 
Step 2: Enter Member Personal Information

For privacy and security purposes, all personal ID information you provide is transmitted via a secure and encrypted Internet connection then stored offline so that it is not accessible via the internet.  Medical information you provide when using the Track Your Plaque program is only identified by your User Name. Track Your Plaque processes applications and payments offline then sends e-mail confirmation of account activation   This method guarantees that no personal ID or medical information can be stolen or traced by any electronic means.
First Name:
Last Name:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
 
Gender:  
Date of Birth: (mm/dd/yyyy)
 
Comments:
 
Step 3: Select Payment Method

If your physician or scan center has given you a promotional code that entitles you to a free trial membership, skip to the next section.  Otherwise, complete the section below.  Notice of membership activation will be made via e-mail upon receipt and processing of application and payment.

Payment Method:  

Full Name On Credit Card:
Credit Card Type:
Card Number:
(Enter digits only with no spaces or dashes)
Expiration Date: /
Card CSC (3 Digits):
The CSC is typically printed on the back of a
credit card (usually to the right of signature strip).
 
Read and Accept Terms and Conditions of Use

Read the Track Your Plaque Terms and Conditions of Use and signify your acceptance by clicking the "I Agree" check box. 
  
I agree to the above Terms and Conditions 
 
Final Step: Submit Your Application

Click the button below to submit your application. Any omissions or errors will be listed at the top of the page along with instructions on what to correct. If your submission was successful you will automatically be taken to the "Welcome" page.