Discount Plan Application
PRODUCTS INCLUDED: DENTAL, VISION, LASIK VISION CORRECTION, AND TEETH WHITENING KITS
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Step 1: Billing Options

Select a billing option:
 
Member Plus Family
/Month
/Year
(A 25% Savings)

*Plus a one-time non-refundable processing fee of $20.00


 
$11.95 billed monthly + $20.00 one time non-refundable processing fee


Total = $31.95 will be charged for your first month, $11.95 will be charged monthly thereafter



When would you like your membership plan to start?


FORM CODE CICONLINEAPP


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