Online Reservation System Sign Up Page

Welcome to our new online ordering registration page! Signing up is (usually) fast and easy.

Note: If you've never visited MOCA before, you will not be able to register online. Email us or give us a call at (773) 722-6622 to set up your account.
We’ll need:
- QP or CG Registration Number
- Address
- Phone number
- Email
- D.O.B.
- Optional: Preferred name/Pronouns

Some instructions:
Please make sure to enter your name and email exactly as they appear in our system and on your patient card. Nicknames (Dave vs David) and other emails besides what we have on file will not work for registration.

Caregivers should just select that option and fill out their own info, NOT the patient's info. Patient online accounts are not required for caregivers to set up their own account to access the system. The patient will need to set up their own account if they wish to use this system also.

In order to access the Online reservation system for MOCA, you must be or have once been a MOCA patient. Former patients may sign up for this system but may not reserve product for pickup until re-designating at MOCA.

Switch back to MOCA HERE.

Please email us at if you have any issues with signing up for our online ordering system.

I am a:
First Name:
Last Name:
Email Address:
Desired Password (minimum 8 characters):
Desired Password (again):
Patient Registry Identification Number: