Health Alliance Membership

Start Your Application

Before beginning the application, check your organization’s membership status by using the search function above. If your organization shows up in the search, you’re already a member with us.

If you’d like to download and print the application, click here.

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2Step 2 of 2

Your Name *(Required)

Job Title

Your Email *(Required)

Your Phone Number

Business / Organization Name *(Required)

Business Phone *(Required)

Number of Employees in Indianapolis' Nine County Region *(Required)

(Boone, Hamilton, Hancock, Hendricks, Johnson, Madison, Marion, Morgan, Shelby)

Business Address *(Required)

Broker Name *(Required)

Broker Company Name *(Required)

Broker Email(Required)

Broker Phone(Required)

Membership Level

Total

Payment Options *(Required)

One-time

Auto-Renew

Payment Information(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Business Address

Street Address Street Address 2 City State ZIP / Postal Code

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An Indy Chamber membership is key to connecting with the regional business community—a group comprised of entrepreneurs, budding small businesses, and enterprises of various industries, locations, and specialties.

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