Follow the steps to complete your WMH Portal registration form.

1. Click the ‘Get Form’ button to obtain the registration form and open it in the online editor.
2. Fill in your personal information in the 'Patient Information' section. This includes your name, date of birth, and Social Security number. Ensure accuracy, as this information is essential for authentication.
3. Provide your current address, including street address, city, state, and zip code. This information must be entered as indicated.
4. Enter your phone number to allow for any necessary follow-up communications regarding your application.
5. Locate your Medical Record Number (MRN) which begins with the letter M. Enter this number without the zeros that may follow it. If you have trouble finding your MRN, contact the Medical Record Department for assistance.
6. Provide a valid email address where you wish to receive your username and password for the portal. Print it clearly to avoid issues with communication.
7. Read and acknowledge the requirements and procedures stated on the form. By signing, you affirm your identity and agree to the terms for accessing online medical information.
8. Sign and date your application in the designated fields to validate your submission. Make sure all required fields are filled out completely.
9. Submit the completed form. Once validated, you will receive your username and password via email within three to five business days. Follow the link in the email to activate your account.

Take the next step to manage your healthcare by completing the WMH Portal registration form online today.