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Please Identify Yourself

Step 1 of 3 All fields are required.



MyThedaCare Activation Code
xxxxx
-
xxxxx
 

If you do not have an Activation Code, please click the button at the bottom of this page. If you have an Activation Code, please enter it into the fields to the left (your code is not case sensitive). You will not need this code after you complete the signup process.

nnnn

Please enter the last 4 digits of your Social Security Number.

Date of Birth
mm
/
dd
/
yyyy

Enter your date of birth in the format shown, using 4 digits for the year.