Please Identify Yourself

Step 1 of 3

All fields are required.

MyThedaCare Activation Code

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

xxxxx
-
xxxxx

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

nnnn
Date of Birth

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

mm
/
dd
/
yyyy