Dorsey Dental: Houston Advantage Plan (Annual Pay)

★ Dorsey Dental Network

General Dentists and Specialists in Houston and all the surrounding areas including Montgomery, Harris, Brazoria, Galveston and Fort Bend Counties ready to serve you, your family and your employees.

○ 20%-60% Savings

★ Dorsey Vision Network

○ 10%-25% Savings

★ Newport Audiology

○ Hearing Aids
○ 30% – 35% Savings

★ Pharmacy Prescription Savings

○ 20%- 60% Savings

★ Mail Order Prescriptions Savings

○ 50%-70% Savings

★ Medical Laboratory Services

○ 50%-70% Savings

★ Dorsey Imaging Network

○ MRI CT Scan Ultrasound
○ X-rays Includes Radiology Report at no additional charge

★ Nutritional Supplements & Vitamins

○ Top Rated Company
○ 50%-70% Savings
○ Save additional 10% with our Promotional Code

★ Annual Plans Get 10% OFF!

★ 30-day money back guarantee. The Setup Fee is one-time nonrefundable.

Coupon or referral code

Customer Information

Email Address *

Phone

Organization

Shipping Information

First Name *

Last Name *

Shipping Address 1 *

Shipping Address 2

Shipping Country *

Shipping City *

Shipping State *

Shipping ZIP Code *

Billing Information

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First Name on Account *

Last Name on Account *

Card Number *

CVV

Expiration Month *

Expiration Year *

Billing Address

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Address 2

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Additional Information

Primary Member | Date of Birth (MM/DD/YYYY)

Primary Member | Gender

Additional Household Member 1 | First Name

Additional Household Member 1 | Last Name

Additional Household Member 1 | Date of Birth (MM/DD/YYYY)

Additional Household Member 1 | Gender

Additional Household Member 2 | First Name

Additional Household Member 2 | Last Name

Additional Household Member 2 | Date of Birth (MM/DD/YYYY)

Additional Household Member 2 | Gender

Additional Household Member 3 | First Name

Additional Household Member 3 | Last Name

Additional Household Member 3 | Date of Birth (MM/DD/YYYY)

Additional Household Member 3 | Gender

Additional Household Member 4 | First Name

Additional Household Member 4 | Last Name

Additional Household Member 4 | Date of Birth (MM/DD/YYYY)

Additional Household Member 4 | Gender

Additional Household Member 5 | Date of Birth (MM/DD/YYYY)

Additional Household Member 5 | First Name

Additional Household Member 5 | Last Name

Additional Household Member 5 | Gender

How did you hear about us?

Setup Fee	$25.00
Recurring Fee (every 12 months)	$139.86
Today's Total	$164.86
then $139.86 at first renewal on 04/19/2025