Welcome to VAULT Direct

This is NOT insurance

Thank you for your interest in VAULT Direct. Please note we don't save the information you enter "in progress", so we need you to fill out the entire form for you and every member of your family who you want on our program.


PLEASE READ CAREFULLY

  • We do not use your social security number to run a credit check, we only use it for identification purposes.

  • We accept all pre-existing conditions.

  • NOW CURRENTLY ACCEPTING NEW MEMBERS FOR A JANUARY 1, 2022 SERVICE START DATE.

  • Your payment for the first month of service will be processed immediately. All future charges to your credit card should appear on, or about, the 20th of each month for the upcoming month of service.

  • Please contact VaultDeptQ@VAULTAdminServices.com prior to the 15th of each month to change your subscription information or cancel your subscription. Charges on your credit card will appear as “WPY*VAULT StrategiesZohoXXXXXXXXX“

  • Members of your household, who may use the services must be included in these information gathering forms. All blanks marked with an “*” are required to provide services. Members of your household must be between the ages of 2 and 65 to use VAULT Direct Services. If individuals do not have their own email address, use the email address of the primary subscriber.

  • When you click [SUBMIT] you will be redirected to our payment system to enter your payment information.

  • After subscribing you will receive an email including the above information and additional details about your subscription.


First Name *

Last Name *

Gender *

Month of Birth *

Day of Birth *

Year of Birth *

SSN *

Email *

Phone *

Address *

Address 2

City *

State *

Zip Code *

Are you adding a spouse?

Are you adding (a) dependent(s)?







TERMS OF SERVICE:

VAULT Direct is not an Insurance Product. This is a subscription for access to virtual (remote) medical services, by appointment only primary and urgent care and a pharmacy program. Services are delivered via telephone based bi-lingual scheduling center and service provider website(s). This service is not intended to replace acute or emergency services. Subscribers are encouraged to seek emergency medical services in any life-threatening situations. Due to availability and state-based regulatory requirements, different service providers may be used in different states. Services are comparable in all geographic areas. Access to these non-insurance subscription services are not intended to provide legal or financial advice.

These Terms of Service include the notices posted on this enrollment website.

Upon termination or cancellation of your account, any information that you access via the service providers will no longer be accessible by you. VAULT Strategies. LLC and VAULT Admin Services, LLC. market and administer the services of 3rd party service providers. For additional information regarding the services provided as part of VAULT Direct, our Privacy Policy or our Cancellation and Refund policies please carefully review the information provided in the application or email VaultDeptQ@VaultAdminServices.com.

Consent to Electronic Communications: You consent to receive disclosures from us electronically through our Website(s) or Mobile App(s), by email, or by text message. By consenting to the electronic delivery of disclosures, you agree that we may provide electronically any and all communications concerning any payments you make to us or any payment plan agreements you enter into with us now or in the future, including disclosures required by state or federal law (the “Disclosures”). To electronically receive and view and electronically save or print the Disclosures, you must have: a personal computer or device with Internet access; a widely-used, recent-generation web browser; a widely-used, recent-generation portable document file reader; the email address you have provided us (or a new email address you subsequently provide us); and a printer, hard drive or other storage device. If the information you have supplied us for contacting you electronically changes, please notify us of your new contact information. You may not withdraw your consent to receipt of electronic disclosures. If you withdraw your consent, you may no longer be eligible for certain services we only offer electronically, and you will not be able to receive disclosures from us electronically or do business with us.

We will make any legally required disclosures of any breach of the security, confidentiality, or integrity of your unencrypted electronically stored personal information (as defined in applicable state statutes on security breach notification) to you via email or conspicuous posting on our Website(s) or Mobile App(s) in the most expedient time possible and without unreasonable delay, insofar as consistent with (i) the legitimate needs of law enforcement or (ii) any measures necessary to determine the scope of the breach and restore the reasonable integrity of the data system.

I have read and accept these Terms of Service

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