Enrollment | AbundaBox

Thank you for your interest in AbundaBox! Complete and submit the following information in order to enroll in the eight free over-the-counter COVID tests per month, plus other goods to keep you healthy, including vitamins, coupons, samples, and a food card that can be used to buy approved healthy foods.

Security and Compliance are paramount priorities for TM AbundaBox and we are committed to ensuring that your data is protected in the cloud. Click here to read more.

Please Enter Your Enrollment Information:

First Name

Middle Initial

Last Name

Gender

Date of Birth

Insurance Id

Insurance Type

Contact Info:

Mobile Phone

Home Phone

Email Address

Mailing Address:

Address 1

Address 2 (Unit or Apt)

City

State

Zip Code

Food Service:

Are you interested in our food benefits?

In order to maximize your enrollment benefit, please check any of the conditions that might apply.

food card benefit or delivery service?
Qualifying Conditions