NeuCare Business
Partner Registration

Please complete the form below to enroll your business as NeuCare partner.
Once completed, we will contact you to finalize things and provide a written agreement for you to sign. 

 
Business Info
Owner of Business *
Owner of Business
Part or Full Time who may be eligible for this benefit.
Business Mailing Address *
Business Mailing Address
Business Phone *
Business Phone
Sponsorship Details
Please consult with your account and/or HR professional, but generally, details of sponsorship must remain consistent across all employees.
Desired Start Date of Service *
Desired Start Date of Service
This is the % of membership fee that the BUSINESS will cover for employees who enroll with NeuCare. Typically, this is between 50-100% of membership fees. Employees will be responsible for 100% of any ancillary charges (e.g. medications, labs, procedures, etc.).
Eligible persons *
Whom will be eligible to join NeuCare under this business account?
We do encourage the business to keep an updated list of eligible members with us, but will verify each new person added to the account.