Contact Us | Leya Health, LLC

Get $100 for referring our services.

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Monday-Friday 8:30am-8pm EST
Saturday & Sunday 9:30am-5pm EST
Office: 786-418-8336
After Hours: 786-872-8027

Available all week, to serve you!

The insurance plan I need is: *

For myself only.
For a family plan (myself included).
For someone else only.
For someone who is not an US citizen or have no green card.

Your Name *

Name of other individuals included in this plan:

Phone Number *

Date of birth & gender for each individual *

Zip code *

Email address *

I am looking for: *

Medical coverage
Dental coverage
Vision coverage
Life insurance options

What pre-existing conditions or prescribed medications in the past two years do you or any member on this plan have? *

How did you hear about us? *

Google
Social Media (Facebook, Instagram, Tumblr, Pinterest, LinkedIn, etc.)
Friend or Family
Other

Please provide us the name of the friend or family member for the referral compensation.

By submitting this form, I consent Leya Health, LLC representatives to contact me via phone or email. I understand that submitting this form is my own freewill. Information on this form is true to my best knowledge. *

Yes, I consent.

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