Employee Request Card New

Employee Card Request

Please schedule an appointment with your practitioner (less than 30 days) before requesting a WellifyME card.

*Allow 5-7 business days for processing.

Please adjust your appointment date to allow processing time.
*Virtual cards can be processed in less time than physical.

Please try again when your appointment is closer.
*Allow enough time for processing (5-7 days).

Appointment Date

Current Date

First Name *

Last Name *

Days until appointment *Try again when less than 30 days

# Days until appointment *Try again when greater than 5 days

# Days until appointment *Try again when greater than 7 days

Employee Email *

Employer ID *

Employer ID can be obtained from your employer.

Type of Card

Virtual

Physical

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