This form is intended for both new subscribers to WellCareTracker
and also those wishing to renew their existing subscriptions.
To Sign Up/Subscribe:
Upon receipt of the payment, the Primary Contact
will receive User IDs and Passwords for all listed users.
- Review the Terms and Conditions of the WellCareTracker Subscriber Agreement.
Click Terms and Conditions to view the
in a new window now. After reading the Subscriber Agreement, please close the window
and acknowledge your
Approval of the Terms and Conditions by clicking on the "I APPROVE" button at the bottom of this page.
Clicking on "I APPROVE" will send the Signature Page with your approval to PA AAP electronically.
- Complete the Primary Contact and General Background information form.
- Complete information on additional users (names and email addresses) and
sites (addresses and phone numbers) if necessary.
NOTE - if there are more than 10 users or 5 sites, we will contact you
to discuss you subscription in greater detail.
- Generate an Invoice with a Balance Due which can be paid: a) Now - online
thru PayPal - a secure website that accepts Mastercard/VISA credit or debit cards,
or bank checking account information; or b) via check though the mail.
Click "I APPROVE" to confirm to PA AAP your approval of the Terms and Conditions
of the WellCareTracker Subscriber Agreement. The next page will be the Primary
Contact and Background Information Page.