Customer 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* : Salutation* : First Name*: Last Name*: Department: Job Title : Main Phone*: Mobile Phone: Entitlement Admin :

Agree to Terms and Conditions

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