Request access to the Kingdom Care client portal. We only collect the information needed to locate the correct client record and verify your account.

Client portal request

Create account request

Tell us your name and the client's name. Submitting a request does not activate portal access. Kingdom Care verifies your email and phone before access is activated.

Your name

Your first nameYour last namePhoneEmail

Client's name

Client's first nameClient's last nameDate of birthClient file number (optional)Relationship to clientI am requesting access as

Do not enter care notes, medical history, diagnosis, insurance or Medicaid numbers, ABA details, or incident information on this form.

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