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Enrollment

GreenWell Health Patient Enrollment

We have two simple ways to enroll!

Working on Computer

Digital Enrollment

Click below to access our completely digital, on-line enrollment process.

To complete your application, please upload all required documentation (copy of insurance card(s), medication list, POA/Guardianship documents) here:

Paper Enrollment

Step 1: Download the enrollment packet here:

Step 2: Fill out the Enrollment Packet


Step 3: Upload the Enrollment Packet, along with all required documentation (copy of insurance card(s), medication list, POA/Guardianship documents) here:

UPLOAD DOCUMENTS

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Or fax, email, or mail all documentation to

GreenWell Health: 
Fax: 480-847-2271
Email: enrollment@greenwellhealth.com
Mail: 2550 E Rose Garden Ln, Unit 72944

         Phoenix, AZ 85050

Insurance Agent

Question about the enrollment process?  Please contact us at (480) 847-CARE ext. 105 or by email enrollment@greenwellhealth.com.

To review GreenWell Health’s Patient Agreement and Disclosure Forms, click HERE

Please Note:

Provided the enrollment form and required documents have been filled out completely and signed, it generally takes 24-48 hours to process an enrollment packet.  If additional information is needed, it may take up to 7 business days to finalize a patient’s enrollment. 

Once enrollment is complete, the patient will be scheduled to be seen at the provider's next visit to the community or residential area.

 

If a patient has an “URGENT” need to be seen, please indicate that at the top of the enrollment form. Criteria for needing an urgent visit would include problems that can’t wait longer than 24-48 hours but are not life threatening.  (Dial 911 for all emergent or life-threatening situations.)

 

The patient should continue seeing their current primary care provider until their initial care visit by a GreenWell Health provider.

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