To set up your account to communicate with your child's mentor/provider, please fill in the information below, and then click on the register button.  Your personal information will be sent by secure transmission and will be kept strictly confidential. If your child's healthcare provider has not agreed to follow your child on this site, please do not register.  Thank you.

Salutation Mr.  Mrs.  Ms.
First Name:
Last Name:
Login Name: Recommend first initial and last name, such as "jsmith" for John Smith
Confirm Password:
  The information below is required to tie you to your child.
Your Child's Login Name:
Your Child's First Name:
  Your Child's Last Name:
  Your Child's Date of Birth:    

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