Apply now

Register your clinic in 5 minutes.

Tell us about your clinic, services, and which zip codes you want to be featured in. We'll review and reach out within 1–2 business days.

Partner application

All fields below are collected via GHL Form 5 (Partner Registration). Submissions land in the Partner Leads pipeline.

GHL FORM 5 (PARTNER REGISTRATION) EMBED GOES HERE

What we collect

  • Business name + DBA
  • NPI / business license #
  • Primary contact name, email, phone
  • Clinic address + zip code
  • Zip codes you want to be featured in
  • Services offered (Rapid HIV, STD panel, PrEP, etc.)
  • Clinic-level offerings (food, screening, transport, dental)
  • Selected pricing tier
  • Existing GHL booking calendar URL (or we set one up)