Confidential Client Registration Form

Please complete your Client Registration using this online form.
Clicking SUBMIT sends the form to the OAJA Administrator’s confidential email.

Please read these directions before completing the form:

• Do not print the form below- it is only to be sent via this web page
• Fill out your paper form first and keep it safe for your records
• Fill out form below by typing in the spaces provided
• When finished, click the “Send” button at bottom – only click once!
• A message will automatically be sent to the office with the information entered in this form
• Once the form has been sent the data entered is not saved; it will be erased when you close your browser window
• You will receive the client registration number by reply email within a week
• Write the client registration number on your paper form
• Repeat this process for each client to be registered
• Now start typing in the form below