Join Our Network

Are you a healthcare provider in US or in the Caribbean who would like to join our provider network? Please select below:

Signing up as a Hospital?

Download and submit an application for Hospitals.

Click here to Download!

Signing up as a Physician?

Download and submit an application for Physicians.

Click here to Download!

After filling out the application, please fax to 312-935-3590 or email: Asanchis@haapp.com

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Join Our Network

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Note: AXA Assistance USA will not use information collected here for marketing or promotional purposes beyond the scope of this transaction. Clicking the Send button signifies that you have read and agreed to our Privacy Policy.