Evern Student Care: Enrollment (Parent or Guardian)

Step 1 of 5
You are completing an enrollment your student started. Please confirm the student's details, add your own, review the agreement and complete payment.
Welcome to Evern Student Care. Enter your student's details, then your own, review the agreement and complete payment.
Student date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Student email
example@example.com

Step 2 of 5
Student legal first name
Student legal last name
Student preferred name
Student mobile phone
Please enter a valid phone number.Format: (000) 000-0000.
Home ZIP code
School ZIP code

Step 3 of 5
Parent or legal guardian full name
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Relationship to student
Email
example@example.com
Mobile phone
Please enter a valid phone number.Format: (000) 000-0000.
I am the student's parent or legal guardian, or otherwise authorized to enroll the student

Step 4 of 5

Membership summary

	Monthly	Annual
Membership	$199 a month	$1,995 a year
Registration fee, one time	$50	none
Charged today	$249	$1,995
Then	$199 a month, from day 30	$1,995 a year

Both plans include the same services. The monthly plan includes two remote advocacy and care coordination sessions a year, the annual plan includes three.

The card you enter on the next step is charged today for the amount above and then automatically at each renewal until you cancel. Cancellation and renewal terms are set out in the Evern Student Care Membership / Service Agreement (final wording is provided by Evern's attorney).

Before you continue: the amount above is charged the moment you submit, in one payment. Banks sometimes decline a larger than usual charge, and if that happens the form has to be filled in again from the start. If you think your bank might block it, call them first or use a card with enough available credit.

I have reviewed and agree to the Evern Student Care Membership / Service Agreement
I authorize the recurring charges for the selected membership and billing terms
I understand clinical consents and health information are completed separately after enrollment

Step 5 of 5
flow
key

Choose your membership

Monthly Membership

$249.00 for the first month then,$199.00 for each month

Annual Membership

$1,995.00 for each year

Email for the payment receipt

Debit or Credit Card
Card number	Security code
Expiration month	Expiration year

Should be Empty: