* = Required Information
Client Referral Submission Details
ABOUT YOUR REFERRAL
Company Name
*
City
*
State
Please select state.
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
First Name
*
Email
*
Phone Number
ABOUT YOU
Referring Client Company Name
*
Referring Client Contact Name
*
Referring Client Email
*
Referring Client Phone Number
Referring Client Street Address
Please indicate the address to which you would like the gift card sent
Referring Client City
*
Referring Client State
*
Referring Client Zip Code
*
Client Number
Submit
How the Metnurse Client Referral Program Works
Complete the referral form at offers.primepay.com/referrals
You will receive a confirmation email upon receipt of the inbound referral form. Any outstanding information will be requested at that time. Once all information is obtained, the referral process will begin.
A Metnurse representative will reach out to the referral contact to schedule a call and/or in-person visit. You will be notified of the status of your referral upon the final result.
Rewards will be processed after 30-days from the date the new 'referred' client is admitted to our care and have received 30-days service. Note: The new 'referred' client must be an active client at the time of rewards payment. Please allow 3-4 weeks for delivery of the Visa Gift card.
Terms and Conditions
Only
PRIVATE
PAY clients are eligible for this program.
Open only to all
Metnurse
clients, consultants, health professionals, and individuals in good standing of the following states: GA and any other state in USA and referred client must live in the 39 approved counties and regions on our website.
Clients must submit referral form to participate. Referral submissions must be received by
Metnurse
on or before January 31, 2014 to be eligible for rewards.
Referrals must be for new accounts only, payable once the referred client has received services from
Metnurse
for at least 30-days. The referred client or individual must receive service within 30-days of admission for all parties to qualify for rewards.
Successful referrals earn a $100 VISA gift card for the individual making the referral.
Incomplete or illegible referrals will not be eligible for reward.
No substitutions for prizes will be permitted and prizes are non-refundable and non-transferable, except at the sole discretion of
Metnurse
.
Metnurse
reserves the right to substitute prizes of equal or greater value.
In the event that two or more
Metnurse
clients refer the same company or individual, the submission with the earliest referral date (verified via time-stamped fax or date-stamped e-mail) will be considered the referring client.
The
Metnurse
Client Referral Program is subject to change and/or termination at the sole discretion of
Metnurse
.
All submitted referrals become the property of
Metnurse
.