Let's Create Your Free Account

Quitting is a journey. Different paths and routes can get you to your end goal. Tell us about yourself so we can give you the best guidance for your journey.

Tell us a little about yourself.
What's your zipcode?

Next, set up your login info and communication preferences

Set up your login!

Sign up for messages with encouragement and advice

  • I understand and agree that: 1) messages to/from BecomeAnEX may have personal details about me, such as protected health information (PHI); 2) Email messages are not secure and it’s up to me to keep them private; and 3) the contact info I provided is mine and I’ll keep it current on BecomeAnEX.

  • I understand and agree that: 1) messages to/from BecomeAnEX may have personal details about me, such as protected health information (PHI); 2) Text messages are not secure and it’s up to me to keep them private; and 3) the contact info I provided is mine and I’ll keep it current on BecomeAnEX.

  • Standard message rates apply. Text STOP to cancel.

Who Referred You to EX Program?

If you were referred to EX Program by your employer, health insurance provider, or another sponsor, that means they have paid for you to access premium features. Please provide the information below to access those features.

If you were not referred here, simply check the boxes below each field.

EX Program features are only available to U.S. residents, so please double check your zip code entered above.

Who referred you to the Ex program?
  • *
  • *