Vitopia Care - Employer Sponsor Registration

Employer Sponsor Network Registration
Sponsor Type
Corp Admin
For Signed Contract Delivery
Employer Sponsor Information
Company Name*
Legal Entity Name
Company Website URL
Optional
Company Address*

Street Address

Street Address Line 2

CityState

Zip Code
TIN/EID*
Number of Members*
Point of Contact Information

This is the person at your company who will handle communications with Vitopia Care.
Point of Contact Name*

First NameLast Name
Point of Contact - Title*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Employee Benefits

Vitopia Care Employer Sponsor Partnership offers a few different opportunities to provide benefits to your Employees.
SPONSORED MEMBERSHIP INFORMATION

You may elect to sponsor your employees with a Vitopia Membership.

Vitopia Save - Free

Vitopia One - $99 per employee, per year

Vitopia 365 - $365 per employee, per year

Sponsored Memberships Invoice example:
Membership Sponsorship*

Vitopia Save - FREEVitopia OneVitopia 365
Sponsored - Vitopia One*

0%100%
Sponsored Percentage - Vitopia 365*

25% ($91.25 per employee/year)50% ($182.50 per employee/year))75% ($273.75 per employee/year)100% ($365.00 per employee/year)
ALLOWANCE INFORMATION

You may opt to allow your employees a credit each month or quarter for nutraceuticals or functional testing.
Nutraceutical Allowance (Per Employee Per Month)*

$15$25$50No allowance
Functional Testing Allowance (Per Employee Per Month)*

$15$25$50No allowance
Nutraceutical Allowance Frequency*

MonthlyQuarterly
Functional Testing Allowance Frequency*

MonthlyQuarterly
Should be Empty:

Employer Sponsor Network Registration

Employer Sponsor Information

Point of Contact Information

Employee Benefits

SPONSORED MEMBERSHIP INFORMATION

ALLOWANCE INFORMATION