myMDTHINK Account Registration

Please complete the registration form below to set up your account. The account is free and all information entered into your account is kept secure and confidential. Once you establish your account, you can apply for services, access your case details, and manage your account information.

Please note that you must have a valid email address to create an account. You will receive an email upon registering with instructions on how to complete registration.

Required fields marked with an asterisk (*)

Your Name

First

Last

Suffix

Are you applying for yourself? *

Yes

I am registering as *

Nursing Homes: *

Role Type: *

If you need additional access, please contact us at help.mdthink@maryland.gov

Community based Organizations: *

Role Type: *

If you need additional access, please contact us at help.mdthink@maryland.gov

Sign-In Information

If you already have any active cases with Maryland Department of Human Services, please use the same email address on record of active cases.

Email*

Confirm Email: *

Password Policy Rules

The new password must not contain your Username.
The new password must be a combination of letters, numbers, and special characters.
The new password must contain at least Two:
     a. Uppercase letters.
     b. Lowercase letters.
     c. Numbers.
    d. Special characters. (~!@#$%^*_+-={}/\][:;?,.)
The new password must be between Fourteen (14) but not exceed twenty (20) characters long.
The new password cannot contain blank space (the Space Bar key).
The new password cannot be any one of the previous twenty four (24) passwords and cannot be a password that has been used in the last twelve months.
The new password must differ from your previous password by at least two (2) characters.

Password*

Confirm Password: *

Personal Information:

Date of Birth*

Gender

Cell Phone

Home Phone

Work Phone

Primary Phone

Residential Address I have no residential address

Address

Apt

City

State

Zip Code

County

Mailing AddressSame as Residential Address

Address

Apt

City

State

Zip Code

County

Authorization/Confirmation

I attest that I have the right to complete applications, view statuses, etc. on behalf of the customers. *

Electronic Signature

First Name*

Last Name*

Current Date*

I (

of Nursing Home Staff), hereby attest that I will only enter or view information on behalf of applicant, authorized representative or guardian for which I have lawfully gained permission from the applicant, authorized representative or guardian. I attest that all information inputs will be provided to me by the applicant, authorized representative or guardian and are true, accurate and complete to the best of my knowledge. I understand and acknowledge that impersonation and/or falsifying information will subject me to administrative, civil and criminal liability under Maryland State statutes:

I (

of CBO Staff), hereby attest that I will only enter or view information on behalf of applicant, authorized representative or guardian for which I have lawfully gained permission from the applicant, authorized representative or guardian. I attest that all information inputs will be provided to me by the applicant, authorized representative or guardian and are true, accurate and complete to the best of my knowledge. I understand and acknowledge that impersonation and/or falsifying information will subject me to administrative, civil and criminal liability under Maryland State statutes:

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