Tell us more about yourself.

We’re looking forward to working with you. The first step is letting us know who you are and how you plan to use DynamiCare.

We will never sell your data.

Your name
Your name
Your phone
Your phone
We collect contact information to communicate about your order. Your contact info will never be shared with other parties.
Who are you signing up?
All members must be at least 13 years old. Minors under 18 years old will require special permission from a parent or legal guardian.
Their name
Their name
If you are signing someone else up, we collect their name so we can reach out to them up for an initial onboarding call.
Their phone number
Their phone number
If you are signing someone else up, we collect their phone number so we can reach out to them for an initial onboarding call.
We will check to see if their insurance covers DynamiCare.
Do they know you are signing them up?
The more information you can provide the better - thank you!
Final questions
You acknowledge that you have read and understand the Privacy Policy and the Terms of Use agreement and agree to be legally bound by them. *
DynamiCare is not a form of treatment or substitute for treatment, and does not provide treatment, but can be used as an adjunct to treatment or as a standalone wellness program to help people achieve healthy goals in relation to substance use. *

Need help? Call us at 855-5-DYNAMIC
(Mon-Fri, 9am-5pm ET)