Welcome! This page allows you to sign up your company or group for AllyHealth telemedicine electronically. Simply complete the form below, upload your member census, and then submit. A member of the AllyHealth enrollment team will then contact you to confirm your information and guide you through the rest of the onboarding process. We look forward to working with you and we hope your team really enjoys our service!

Need help using this page? Don't hesitate to call AllyHealth at 215.543.7400 or email us at enrollment@allyhealth.net

First, Please Download AllyHealth's Member Census Template File with the link below:

You hereby authorize AllyHealth to charge you by the above-referenced payment method. You also hereby authorize AllyHealth, its agents, affiliates, and vendors, to offer our services to your eligible employees/members subject to the following terms and conditions:

1. You agree to provide us with census data if needed for us to determine proper enrollment eligibility.
2. For voluntary enrollments, you agree to provide a suitable location on your property during normal business hours, or through other means mutually agreed upon between you and us. Participation in your group must meet our minimum participation requirements. We reserve the right to withdraw from the enrollment and cancel any applications already obtained if these conditions are not satisfied.
3. We customarily bill you around the 1st of each month for services to be provided in that month. You agree to forward the membership fees due to us by the 25th of each month for the month in which you are billed.
4. This Agreement is subject to the Group Terms and Conditions, which are available for download and print from the following location: "www.allyhealth.net/group-terms-conditions/

I agree that no member services will be effective until approved by us at our administrative office.