VIP Membership  

 

  • VIP Access to a National Network of Elite Physicians
  • Same or Next Business Day Appointments to the Team Doctors
  • Expedited Appointments to World Class Specialists
  • Limited Wait Times at the Team Doctor’s Offices
  • Personal Advocates to Coordinate your Office Visits
  • Proactive Preventative Care
  • VIP Access to Top Dieticians and Trainers
  • Access To International Travel Pre-Trip Planning
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Primary Member Name* :

Primary Member Age* :

Primary Phone* :

Primary Email* :

Primary Billing Address* :

Shipping Address* :

Spouse Name:

Spouse Phone:

Spouse Age:

Spouse Email:

Dependent 1 Name:

Dependent 1 Age:

Dependent 2 Name:

Dependent 2 Age:

Dependent 3 Name:

Dependent 3 Age:

Dependent 4 Name:

Dependent 4 Age:

Dependent 5 Name:

Dependent 5 Age:

Dependent 6 Name:

Dependent 6 Age:

Dependent 7 Name:

Dependent 7 Age:

Dependent 8 Name:

Dependent 8 Age:

Name of friend or company who would be interested in learning more about Team Doctors:

Phone:

Email:

Who referred you to Team Doctors:

Name:

Email:

Phone: