Client Portal Registration Request

Client Portal Registration Request

If you would like to access the Thrive Client Portal, please fill out this registration request. A registration code will be sent to your email within 24 business hours. If you need faster access to the portal, please call the office between the hours of 9am and 5pm at 410-780-5203
If you have previously registered for the portal and have a username and password, please log in here: Client Portal
Name of Person Requesting Access*

First NameLast Name
Birthdate of Person Requesting Access*

MonthDayYear
Date
Email of Person Requesting Access*
example@example.com
Phone Number of Person Requesting Access*
Please enter a valid phone number.
Name of individual receiving services from Thrive Behavioral Health:**Enter "Self" if you are requesting access for yourself.*
Relation to individual receiving services from Thrive Behavioral Health:**Enter "Self" if you are requesting access for yourself.*
Should be Empty: