Organization Application

Apply to bring your practice into Leo.

Tell us about your practice. We’ll review your application + supporting documentation, get the BAA signed, then open your account.

The org beta is in development. We’re building out the Business Associate Agreement and the org admin tools. Joining the waitlist holds your spot — we’ll reach out when there’s something ready for your practice to try.

Three months free for the whole practice at launch for every org that beta-tests with us. Every seat. No card up front.

You don’t need to upload anything yet. After we review your application, we’ll send a secure upload link for: organization NPI, tax ID, state registration / lease, malpractice insurance proof.

About your practice

Practice name (as patients know it)*

Practice type*

Primary specialty*

Active clinicians*

Active patients

Optional, approx is fine

Locations*

Where you’re based

City

State

We’ll ask for the rest (NPI, tax ID, full address, malpractice documentation) once the org beta opens and we’re ready to bring you in.

Who we should talk to

Full name*

Title at the practice*

Email*

Phone

Tell us why

Why are you interested in Leo for your practice?

Optional but valued — helps us prioritize

What’s your single biggest between-visit pain point?

Optional

I understand the org beta is in development and that we’ll be invited in once Leo’s organization BAA is in place and there’s something ready for our practice to try.

We won’t share your info. Used only to verify your practice and onboard you when beta opens.