Subscribe! Subscribe to RDHAPConnectSubscription$40.00Choose your plan: $40.00 charged Quarterly or $120.00 charged YearlySelect Your Payment CycleQuarterlyYearlyPlease Signup* Username * * First Name * * Last Name * * Email Address (Business) * * Password * Strength: Very Weak* Confirm Password * * ConsentPlease share my practice informationDo not share my practice information, but add me to your email list* RDHAP License Number * Phone number * Counties you can serve * * Populations you serveAdults w/DisabilitiesFrail elderlyChildren w/disabilitiesTitle 1 schoolsOther* Services provided * * Practice TypeTravelingFree-Standing officeFree-standing office address Languages spoken Type of Insurance accepted Website (URL) Referred By Whom Who referred you to RDHAPConnect?* PermissionDo you grant permission to publish your information?Done(Use Cropper to set image and use mouse scroller for zoom image.) Select Your Payment GatewayStripeHow you want to pay?Auto Debit PaymentManual PaymentEnter Coupon CodeApplyPayment SummaryYour currently selected plan : , Plan Amount : Final Payable Amount: Join RDHAPConnect!
