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Partner with LifeMap
We’re excited you’re interested in becoming a LifeMap producer. When you work with us, you have the strength and financial stability of a partner always here to support you. Plus, choices to offer your clients that reduce costs, expand access to care, and improve health and well-being.
Our producer application should only take you a few minutes to complete. Once you’ve submitted it, you can expect to hear back from us within ten business days.
Follow the steps below to get started.
Have your agency and producer license numbers, W-9 with your EIN or social security number, E&O insurance in your name, and a voided check for EFT on hand.
Fill Out Form
- Download the PDF application (right click and save as)
- Complete all the questions and save the application
- Click on "Submit Form" directly below and follow the indicated instructions
Please submit your completed application to the Agent Onboarding team by clicking here.
We’re here for you
For questions regarding the status of your application and agent onboarding, please contact our Agent Desk at 1(503) 225-4960.