Choose Your GolfRx Membership
Choose Your Reimbursement Level
*
$0
$150
$300
$1,000
Monthly Subscription
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GolfRx Wellness Membership
Each membership includes guided GolfRx tools, ongoing support, and monthly reimbursement benefits (if selected) for golf activities.
USD
for the
first month
then,
USD
for each
month
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State - 2 Letter Abbreviation
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Do you have an HSA?
*
Yes
No
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