Apply to Join Our Specialist Network

At The Lanby, we prioritize seamless, high-quality specialty care for our members by partnering with top-tier, like-minded specialists who share our commitment to root-cause, patient-centered medicine. If you're interested in becoming part of our Vetted Specialist Network, submit your information below.

By joining our network, you'll be considered for expedited referrals from our care teams, ensuring collaborative, well-coordinated care for our members. Our team will reach out if there’s a strong alignment. 

Sign in to Google to save your progress. Learn more
Email *
What is your full name? *
What is your specialty? *
Are you in or out of network with insurance? *
Where is your practice based?  *
What states are you licensed in? *
Please provide a short description of your practice *
Please add a link to your practice's website or online profile *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Lanby.

Does this form look suspicious? Report