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Become a Vendor

Dear Retailer:

Thank you for choosing to become a vendor participant in the MyHealthy Advantage program, which is dedicated to the health and well-being of area residents 55 and over, at no charge, in the Central Connecticut region. MyHealthy Advantage is brought to you by Hartford HealthCare. Hartford HealthCare is a diversified health care system that includes MidState Medical Center, Hartford HealthCare Senior Services and VNA HealthCare. We believe you will find our relationship to be a rewarding one, both in terms of increased business and in the satisfaction of knowing you are partnering with an outstanding group of local health care facilities.

We ask that you complete the form below so that we may add you to the list of active vendors in our program.

Again, thanks for partnering with us. We welcome you to the growing list of vendors who are helping us to make the MyHealthy Advantage program a huge success!

Sincerely,
Sharon Robinson
MyHealthy Advantage


Are you an existing vendor? Please click here.


All fields marked with * are required.

Primary Contact First Name *
Primary Contact Middle Name
Primary Contact Last Name *
Name of Vendor *
Address 1 *
Address 2
City *
State *
Zip Code *
Phone *
Phone Extension
Fax
Email Address
Discounts
Restrictions
 
I accept the terms and conditions below *


  When it is presented by our members, you agree to honor your commitment to provide the above-stated premium or discount, until such time as you end your participation in the program, or Central CT Senior Care ends your participation, or the program itself is terminated. Vendors are free to withdraw from the program at any time. We ask that you notify us in advance of the date you no longer wish to participate, and prior to withdrawing your discount to our cardholders.
  Please read carefully: The sponsoring members of My Healthy Advantage cannot be held responsible or in any way accountable for adverse events or legal disputes occurring in connection with discount offerings, products or services provided by participating MyHealthy Advantage vendors.
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