Client Portal Under 18

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To sign up for access to view information in the client portal, please complete the form below.

What's Next?

We will email a secure email with your username and a temporary password to you after the information you have submitted is validated with your Woodland Centers client information. You will be able to change this password during your initial log-in.

If you have any questions, email your questions to portal@wcenters.org and they will be answered as soon as possible.

Your Information
Name of Person Requesting Access to Another Client's Record*
First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Relationship to Client*
Client Information
Name of Client*
First Last
SSN (last 4 digits)*
XXXX
Date of Birth*
Date Format: MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Email
Phone*
Primary Clinic/Provider*
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What's Next?

Your Information

Client Information

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