Altrua-POH Guidelines




Annual Membership Commitment

Upon enrollment, the primary contact of the household must sign the Membership Commitment form. The primary Contact's signature represents the continued commitment by each member of the household acknowledging their continued commitment to the:




Submit a Reimbursement Online




HIPAA Release Form via Docusign




Manifest RX prescription discount plan




Telemedicine (Only available to Classic members)

Members have direct access to state-licensed and fully credentialed doctors, via phone or video consultations, to receive treatment and advice for common ailments, including colds, the flu, rashes and more. Doctors are available 24 hours a day, 365 days a year, allowing members and their families convenient access to quality care from home, work or on the go. When medically appropriate, a DialCare doctor may prescribe a short term, non-DEA controlled medication that they can pick up at the pharmacy of their choice. Members can conveniently connect with a doctor with no consult fee. Following conditions can be treated.




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Filling and Signing

You may fill and sign any of our forms and email them using the free Adobe Acrobat Reader.
Please follow these instructions to add your signature before sending.



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Altrua Ministries (dba Altrua HealthShare) is NOT an insurance company nor is the Membership offered through an insurance company. Members are self-pay patients. Altrua Ministries is a 501(c)(3) nonprofit corporation.