Dorsey Dental: National TeleMedicine Plan (Monthly Pay)

★ DialCare TeleMedicine

○ 24-hr Physician Consultation
○ Call a doctor night or day for advice or prescription needs.
○ Call or Request via Mobile App
○ Includes Entire Household
○ Not Available in WA, VT, FL, UT

★ Pharmacy Prescription Savings

○ 20%- 60% Savings

★ Mail Order Prescriptions Savings

○ 50%-70% Savings

★ Annual Plans Get 10% OFF!

★ 30-day money back guarantee. The Setup Fee is one-time nonrefundable.

★ All Plans Include Your Entire Household.

Coupon or referral code

Customer Information

Email Address *

Phone

Organization

Shipping Information

First Name *

Last Name *

Shipping Address 1 *

Shipping Address 2

Shipping Country *

Shipping City *

Shipping State *

Shipping ZIP Code *

Billing Information

All transactions are secure and encrypted.

First Name on Account *

Last Name on Account *

Card Number *

CVV

Expiration Month *

Expiration Year *

Billing Address

Use Shipping Address

Use a different Billing Address

Address 1 *

Address 2

Billing Country *

Billing City *

Billing State *

Billing ZIP Code *

Additional Information

Primary Member | Date of Birth (MM/DD/YYYY)

Primary Member | Gender

Additional Household Member 1 | First Name

Additional Household Member 1 | Last Name

Additional Household Member 1 | Date of Birth (MM/DD/YYYY)

Additional Household Member 1 | Gender

Additional Household Member 2 | First Name

Additional Household Member 2 | Last Name

Additional Household Member 2 | Date of Birth (MM/DD/YYYY)

Additional Household Member 2 | Gender

Additional Household Member 3 | First Name

Additional Household Member 3 | Last Name

Additional Household Member 3 | Date of Birth (MM/DD/YYYY)

Additional Household Member 3 | Gender

Additional Household Member 4 | First Name

Additional Household Member 4 | Last Name

Additional Household Member 4 | Date of Birth (MM/DD/YYYY)

Additional Household Member 4 | Gender

Additional Household Member 5 | Date of Birth (MM/DD/YYYY)

Additional Household Member 5 | First Name

Additional Household Member 5 | Last Name

Additional Household Member 5 | Gender

How did you hear about us?

Setup Fee	$25.00
Prorated Fee (normally $15.95 recurring on the 1st day of each month)	$2.54
Today's Total	$27.54
then $15.95 at first renewal on 05/01/2024