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HealthNet Connect

Have you ever had a healthcare problem and had difficult to find the right Doctor or Health Provider for your specific needs?

Imagine to have all the knowledge and insides information about healthcare system, providers and doctors at one phone call or email away, plus having a first hand guidence, help and support from health specialist and doctors. Guidance, transportation and translation for your healthcare needs. All these and more benefits will give you the PEACE OF MIND you deserve while you are retiring in the Yucatan peninsula.

HealthNet Connect 

HealthNet Connect provides quality, affordable medical and wellness services and assisting with the language barriers. We will provide information regarding hospitals, doctors, treatments and procedures, and help you select the best medical provider for your individual needs. Using our experience and research we offer you PEACE OF MIND that you will always have the best treatments and procedures, doctors and medicine at the most cost effective way.

    Name(First & Last)

    Date of Birth:

    Home Address:

    City:

    Cell Phone Number:

    Email:

    Do you have a health insurance: yesno

    Which one:

    Full time in Mexico: yesno

    If no, how many months will you live in Merida:

    Membership
    Start Date:


    Valid until:

    Do you have or have you had any of the following diseases or conditions?

    Condition

    Condition

    Condition

    Diabetes: yesno

    Hepatitis B, C or Cirrhosis: yesno

    Rheumatoid Aitritis: yesno

    Hypertension: yesno

    Renal insufficiency: yesno

    Lung diseases: yesno

    Vascular brain: yesno

    Cancer: yesno

    Connective tissue disorders: yesno

    Psychiatric: yesno

    Leukemia: yesno

    AIDS: yesno

    Hearth: yesno

    Lupus: yesno

    Alcohol or drug abuse: yesno

    Do you have any chronic or congenital condition not mentioned or pending treatment or surgical intervention?

    Emergency Contact

    Name:

    Relationship to member:

    Country of residence:

    Country code:

    Phone Number:

    Address:

    Email:

    I HAVE READ, UNDERSTOOD AND AGREE TO THE TERM & CONDITIONS

    HealthNet Connect Terms & Conditions are also available at www.healthitinerary.mx

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