LifePoint Sign Up

Please select the type of signup you wish to complete:

I want to add a hospital or clinic group for the first time

I want to add a department, clinic or location for a hospital or clinic group that has already signed up

The Contact name and email address must be the person authorized to sign the contract with Tavoca

My Name Is *

Lifepoint Hospital or Group *

Primary Business Telephone Number *

Website Address *

We do not have a website *

Business Name * Department or Clinic Name *

Billing Address *

City *

State *

Zip Code *

Each department will be invoiced separately. Please indicate how you want to receive invoices *

Scheduling Software / EMR

Create a Username *

Create a Password *

Confirm Password *

Primary Contact First Name *

Primary Contact Last Name *

Contact's Email Address *

Contact's Phone Number *

Extension

Billing Contact Name

Billing Contact Email

Tavoca will send you an electronic version of the contract to sign.

A BAA is already in place between Tavoca and LifePoint. No additional BAA paperwork is required.