VitâgeLab - International

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Application form

Join our Health System as an Affiliate Practitioner for Free

No membership No subscription.

Please fill out each field completely.

Note: VitâgeLab® does not accept business from New York State.

General information

Name of your Company or Clinic (Optional)

Title/Degree

NPI/License Number *

First Name *

Middle Name

Last Name *

Select your Gender *

Preferred Language *

Contact details

Your Email *

Your Email (again)*

Phone*

Address Line 1*

City*

State*

Zip Code*

Country*

Communication

Do you consent text message communication?

Yes

Do you consent SMS message communication?

Yes

Files

To validate your application, we require the upload of a copy of your NPI, you may use the following file formats: .jpg, .jpeg, .png, .pdf (recommended).

Upload here a copy of your practitioner licence/NPI

Please be advised that our laboratory testing services are not eligible for reinbursment or payment through insurance. Additionally, we do not issue superbills for submission to insurance providers.

Yes, I understand that by selecting "Submit Application", I have read & acknowledge the Privacy Policy and I have valid ordering credentials to place lab orders for my patients. I also agree to abide by the Terms of Use.

Dear Health Practitioners

We are excited to invite you to become an affiliate of our cutting-edge health system. As a valued practitioner, you will have the opportunity to collaborate with a world-class clinical platform, dedicated to the highest standards of safety, professionalism, ethics, and personal responsibility.

Why Join Us?

Access to Advanced Testing: Gain access to our comprehensive range of specialized tests, including genetic, functional, and hormonal assessments.
Seamless Integration: Utilize our innovative VitâgeLab® Pro platform to manage patients, order tests, make online payments, and receive results, all in one place.
Top-Notch Security: Rest assured that our platform employs the latest security measures to protect patient data and ensure confidentiality.
Continuous Support: Benefit from our dedicated support team, ready to assist you with any questions or needs you may have.

Benefits for Your Practice

Enhanced Patient Care: Provide your patients with accurate and timely diagnostics that support personalized treatment plans.
Streamlined Workflow: Enjoy the convenience of our user-friendly platform that simplifies administrative tasks, allowing you to focus more on patient care.
Professional Growth: Stay at the forefront of medical advancements with our ongoing education and training opportunities.

How to Become an Affiliate

Joining our health system as an affiliate practitioner is simple. Fill in the application form above, or contact us today to begin the registration process. We will provide you with all the necessary information and credentials to access our online platform.

We look forward to welcoming you to our network of esteemed healthcare professionals and working together to improve patient outcomes through superior clinical diagnostics.

Warm regards,

The VitâgeLab Team

Complete the following form to start your signup process.