ideal Health Plan™ Providers – Sign Up Please fill the below fields and submit the form. We will revert to you at the earliest.Your Organisation Type *SelectHospitalClinicLabPharmacySalutation *SelectDr.Mr.Mrs.Ms.First Name *Last Name Email *Phone Preferred Time to Contact *Organisation Name *Org. Website Address *Message VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank: