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Doctor On-BoardTM Request

To subscribe to Doctor OnBoardTM:

  1. Read the sample Doctor OnBoardTM Agreement, so that you understand the terms and conditions of this service.
  2. Select your service level from the fee schedule below. Clicking on the subscription level you want will take you to the subscription request form.
  3. Complete and submit your subscription request form. You will then be taken to your Doctor OnBoardTM Agreement.
  4. Print the Agreement and sign both the Agreement and the Disclaimer sections in the spaces provided.
  5. Fax or mail your signed Agreement to MariSafe toll-free at 866.962.7472 or at:
Doctor OnBoardTM
MariSafe, Inc.
7455 16th Street East, #107
Sarasota, FL 34234

Note: Your Doctor OnBoardTM subscription will be activated when we receive your signed Agreement.

Coverage Type Regular Price MariGuardTM Members
1-5 Persons, 30 Days$50.00$45.00
1-5 Persons, 90 Days$140.00$120.00
1-5 Persons, 6 Months$245.00$220.00
1-5 Persons, 1 Year$425.00$375.00
6-10 Persons, 30 Days$100.00$90.00
6-10 Persons, 90 Days$275.00$240.00
6-10 Persons, 6 Months$495.00$435.00
6-10 Persons, 1 Year$860.00$750.00
10-20 Persons, 30 Days$200.00$180.00
10-20 Persons, 90 Days$560.00$485.00
10-20 Persons, 6 Months$990.00$875.00
10-20 Persons, 1 Year$1,710.00$1,500.00
21+ Persons, 30 Days$300.00$270.00
21+ Persons, 90 Days$830.00$730.00
21+ Persons, 6 Months$1,500.00$1,300.00
21+ Persons, 1 Year$2,575.00$2,250.00

 


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