Support Portal – New User Registration

Please fill in the fields below. Required fields are marked with an asterisk (*).
Your ActiveCare maintenance contract includes your company’s login credentials.

Company Information Organization Name*: ActiveCare Username / Customer ID*: ActiveCare Password / Entitlement ID*:

Individual Information Email Address*: First Name*: Last Name*: Department: Title: Main Phone*: Mobile Phone: Entitlement Admin:

Agree to Terms and Conditions

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