Join Our Network

Why join Healing Heroes Network? There are many members of our Armed forces who have given so much to protect our country and its way of life. These veterans are in urgent need of your expert medical support.

Authorized Network providers include, but are not limited to: Medical, Dental, Vision, Acupuncture, Physical Therapy, Counseling, Chiropractic and Hyperbaric services. All areas of healthcare are welcome.

* Required Information

Provider's First Name (*)	Please type in your first name.
Provider's Last Name (*)	Please type in your last name.
Street Address (*)	Please type in your street address.
City (*)	Please type in your city.
State (*)	--Please Select--AKALARAZCACODCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Please select your state.
ZIP Code (*)	Please type in your ZIP code.
Phone (*)	Please type in your phone number.
Fax
E-Mail (*)	is not a valid e-mail address.
Website
Specialty (or area of practice) (*)	Please give a description of your specialty/area of practice.
Professional Designations (MD, DC, DDS, PT, AP, etc...) (*)	Please type in your professional designations
(*) YES! I want to help these troops by donating services - Please have a representative contact me! Please check the box to indicate your choice.
How did you hear about HHN? (*)	Please tell us how you heard about us.
Disclosure: This is a preliminary questionnaire to initiate contact with a Healing Heroes Network representative. Completion of this form does not guarantee the membership requested will be approved. Additional information may be required to determine eligibility.
Security Verification (*)	Please enter the 4 letter security code you see into the box.