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Scroll.care Care Broker Application

Fill out the form below and complete the payment for your required background check to apply. Our Broker Managers will contact you with the next steps within 1-2 business days.

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Please provide us with your name:*
What is your home address?*
What is your company's address?*

Representative

Representative Name

Broker Agreement and Background Check Authorization

By agreeing to these consent forms, you are taking the final step in submitting your application to become a Scroll.care provider. After you click 'Submit', you will be redirected to a secure payment page to complete the $89 background check fee. This payment is required to finalize your application.

Important: Your application will not be submitted for approval until the background check fee is paid. If you choose not to complete the payment, your application will remain incomplete and will not be considered for approval.

Once you've completed the payment, your application will be officially submitted, and we'll begin processing your background check through our partner, Checkr. We'll keep you updated on the status of your application via email.

Please review the following consent forms carefully before proceeding:
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