Member Registration

Use the form below to signup for an account with Connect2Docs.

As part of the registration process your credit card will be charged for $1.00 which helps us ensure the card is valid, however this transaction will be voided within 72 hours.

Your Teladoc membership is NOT activated immediately. You will receive a confirmation email once it is activated within 2 business days from the date of purchase.

If you do not currently have a referral code, please call us at 937-867-3627 or email us at to receive one.

If you are a business attempting to enroll your company/employees, please contact the member who referred you to this site for the proper enrollment forms.


Billing Information

Please enter the billing information below as it appears on your credit card.

First Name:
Last Name:
Adddress 1:
Address 2:
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Primary Phone:
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Plan Information

Please select the plan you wish to use and enter your credit card details. Date of birth is required to enable your subscription.

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