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Welcome to Apaly Health!

Crowdsourced Provider Access

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Healthcare Organization Sign Up

Username:

First Name:

Last Name:

Title:

Email:

Re-Enter Email:

Password:

Re-Enter Password:

Legal Name of Healthcare Entity:

Account Nickname: (Used for your public profile)

Type of Organization: (Click all that apply to your organization)

Hospital / Health System

Laboratory

Doctor Office / Medical Group

Imaging Center

Ambulatory Surgery Center

Home Health Provider

DME Vendor

Number of Providers: (All providers, including Mid-Levels, that bill through the organization)

Accept Terms: By checking the box and clicking “Sign Up” you represent that: (1) you have read and agree to the Apaly Health Platform Terms of Service Agreement, and (2) you have the right, authority and capacity to enter into the Apaly Health Platform Terms of Service Agreement on your own behalf, and on behalf of the healthcare organization you have entered above, as applicable.

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