Age has its advantages
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SIGN ME UP!
Lifetime membership fee: $10 Individual, $15 Couple
Apply online at www.IchooseNNMC.com or print this page and complete the information requested below for
individuals or couples. Payment must accompany this application. Allow 4-5 weeks for processing.
| Applicant's Name (Please Print): | Birthdate (mo/day/yr): | |
| Co-applicant's Name: | Birthdate (mo/day/yr): | |
| Applicant's Signature: | ||
| Co-applicant's Signature: | ||
| Address: | ||
| City: | State: | ZIP: |
| Co-applicant's Address: | ||
| City: | State: | ZIP: |
| Telephone (home): | Telephone (work): | |
| Co-applicant's Telephone (home): | Telephone (work): | |
| Email: | ||
| Co-applicant's Email: | ||
| Applicant's Physician(s): | Co-applicant's Physician(s): | |
| Insurance Provider: | ||
| Co-applicant's Insurance Provider: | ||
| Is applicant a veteran? | Today's Date: | |
| Yes No | ||
| Is Co-applicant a veteran? | ||
| Yes No | ||
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Choosing Senior Advantage is a great way to continue your active, healthy life. It's all about maintaining good health… and about terrific cost-saving advantages for you. Senior Advantage offers a wide variety of health benefits including:
- Discounts on health fair screenings
- Free quarterly seminars
- Quarterly health newsletter
- 10% gift shop discount
- 20% discount on all meals in the cafeteria
- Complimentary newspaper delivered to your hospital room
- Free private billing review when hospitalized
Northern Nevada Medical Center accepts Medicare supplements.
This is not an insurance plan.
To ensure program enrollment, payment and all information must be submitted in full. Simply mail
payment and this form to Senior Advantage, NNMC Marketing, 2375 E. Prater Way, Sparks, NV 89434.
All information will remain confidential. If you have any questions, please contact us at
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Northern Nevada Medical Center 2375 E. Prater Way, Sparks, NV 89434 775-331-7000 |
