Enrollment Application

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Create your account

First Name *

Middle Name

Last Name *

Email Address *

Confirm Email Address *

Password *

Confirm Password *

Part of an Employer group?

If your employer is offering you a membership with Solidarity HealthShare℠ and you have received their group number, you can enroll as a part of their group by adding in the group code.

Are you a part of a group?

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Group Number

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