Join the Access Healthcare Direct Network
If you would like to join AHD's network complete these questions and type your name at the end. We will review the application and when approved typically have your practice uploaded on the DPC Doc FInder and employer platforms within 1 week. You will receive a welcome packet by email when complete. Welcome to Access Healthcare Direct.
* Required
Provider name & Practice name
Your answer
Practice Phone & Address
Your answer
Practice Website
Your answer
Email address: * a copy of your application will be emailed to you.
Your answer
Do you want to join the Access Healthcare Direct Network of Direct Primary Care Practices?
Yes
No
Would you like us to market to employers and patients on your behalf through our phone apps and DPC Doctor finder, the Accresa platform, and our website. Copy link and complete question to be listed.
https://forms.gle/vBynTxBFnRfT5q7PA
Yes
No
Are you a Direct Primary Care practice by the current accepted definition and not planning on billing any insurance companies or Medicare?
Yes
No
Are you currently Board Certified or Eligible?
Yes
No
Other:
Have you ever had a malpractice claim?
Yes
No
Please indicate in this box common services that you include in your DPC membership at no additional charge (office visits, physicals, etc)
Your answer
How much capacity do you have for new patients?
1-199
200-499
500-799
800-1000
What is the average monthly fee you will be charging?
$25 - $59
$60 - $65
$66 - $85
$86 - $150
Other:
Do you agree to the terms below: If so type your name here to sign electronically
*
Your answer
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