Wellness Plan Registration – ActiveCare Clinic

Account Details

E-mail *

First Name

Last Name

Password *

Repeat Password *

Select Your Wellness Plan
Wellness Plan - Family of 4 (Annual) - $799.99 for 4 members / 1 Year
Coverage for Uninsured Services, Secure Messaging, Online Appointment Booking, No Fee Prescription Renewals (online or faxed)
Wellness Plan - Family of 4 - $79.99 for 4 members / 1 Month
Coverage for Uninsured Services, Secure Messaging, Online Appointment Booking, No Fee Prescription Renewals (online or faxed)
Wellness Plan - Family of 3 (Annual) - $599.99 for 3 members / 1 Year
Coverage for Uninsured Services, Secure Messaging, Online Appointment Booking, No Fee Prescription Renewals (online or faxed)
Wellness Plan - Family of 3 - $59.99 for 3 members / 1 Month
Coverage for Uninsured Services, Secure Messaging, Online Appointment Booking, No Fee Prescription Renewals (online or faxed)
Wellness Plan - Family of 2 (Annual) - $399.99 for 2 members / 1 Year
Coverage for Uninsured Services, Secure Messaging, Online Appointment Booking, No Fee Prescription Renewals (online or faxed)
Wellness Plan - Family of 2 - $39.99 for 2 members / 1 Month
Coverage for Uninsured Services, Secure Messaging, Online Appointment Booking, No Fee Prescription Renewals (online or faxed)
Individual Wellness Plan (Annual) - $249.99 / 1 Year
Coverage for Uninsured Services! Secure Messaging, Online Appointment Booking, No Fee Prescription Renewals (online or faxed)
Individual Wellness Plan - $24.99 / 1 Month
Coverage for Uninsured Services, Secure Messaging, Online Appointment Booking, No Fee Prescription Renewals (online or faxed)

You have selected a Group Membership. After a successful payment you will be able to invite up to %s additional members.

Add Your Group Details

Group Name *

Group Description

Payment Details

Account Details

Select Your Wellness Plan

Add Your Group Details

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