TeleDirectMD — Broker Partner Inquiry

TeleDirectMD — Broker Partner Inquiry

For licensed benefits brokers and consultants interested in referring employer clients to TeleDirectMD’s $59/month virtual primary care benefit and earning a $250 finder’s fee per signed employer contract.
Broker Full Name

First NameLast Name
Agency or Firm Name
NPN / National Producer Number
Resident State of License
Other States Licensed In
Work Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Approximate Number of SMB or Mid-Market Employer Clients
Primary Industries You Serve

Other
Do you have an employer prospect ready to discuss?
If yes, briefly describe the prospect
I confirm I am NOT a Florida-licensed broker and the referred employer is NOT a Florida employer. I understand the Florida Patient Brokering Act prohibits this referral arrangement in Florida.
By submitting, I consent to receive calls, texts, and emails from TeleDirectMD at the contact info provided. Message and data rates may apply. Reply STOP to opt out.
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