Help complete your enrollment online
If you have been directed to this site by your doctor, it may mean your signature is needed to complete your Interconnect enrollment. Click the button below to electronically sign your Patient Authorization form.
If you have been directed to this site by your doctor, it may mean your signature is needed to complete your Interconnect enrollment. Click the button below to electronically sign your Patient Authorization form.
You are now leaving Interconnect
Any information you provide after you leave this site and enter another site will be subject to the other website’s privacy policy and terms and conditions. Interconnect is not responsible for the use, security, or disclosure of any information you may provide to another site.
The information on this site is intended for healthcare professionals in the United States, its territories, and Puerto Rico, and is not intended for the general public.