{{ csrfToken("portal_index_reset", "csrf_token_form") }} {% if isSubmit and not isSaved %}

{% if errMsg is not empty %} {{ errMsg|text }} {% else %} {{ "A system error occured - try again or contact your healthcare support staff"|xlt }} {% endif %}

{% endif %}

{{ 'Change Username'|xlt }}

{{ 'Confirm Username'|xlt }}

{{ "Enter a minimum of 8 characters. Recommended to include symbols and numbers but not required."|xlt}}

{{ 'Change Password'|xlt }}

{{ 'Confirm Password'|xlt }}

{{ "Password must be at least 8 characters with at least one uppercase,one lowercase,and one number."|xlt}}

{# it looks nicer just to have the text be in the input but screen-readers won't display placeholder text reliably #}

{{ 'Enter your current Account Password to authorize these changes'|xlt }}

{# Note we don't via JS validate the current password just in case security requirements have changed #}

{{ 'Use this form to change your Account Username, Account Password, or both.'|xlt }}

{{ 'You can change your current Account Password by entering a new Account Password and then entering the same Account Password into the Confirm Password field'|xlt }}

{{ 'You can change your current Account Username by entering a new Account Username and then entering the same Account Username into the Confirm Username field'|xlt }}

{{ 'Any change to your Account Username or Account Password requires you to enter in your current Account Password into the Confirm Current Password field.'|xlt }}

{{ "For additional help or questions you can contact your healthcare support staff."|xlt }}

{{ "The following fields can be used to help your support staff locate your account."|xlt }}

{{ 'Portal Account ID for reference'|xlt }}

{{ 'Patient Identifier'|xlt }} (pid)

{{ "Account Username"|xlt }}

{{ "Account Password"|xlt }}

{{ 'Enter your current Account Password to authorize these changes'|xlt }}