PRISMA Health Employee Discount Program

Fill out the form below to get started

Name(Required)
MM slash DD slash YYYY
Home Street Address(Required)
Emergency Contact Name(Required)
(Please select Branch you will use the most or live closest to)
YMCA Waiver of Liability(Required)
Prisma Health Waiver(Required)
The next page will confirm your submission. We will confirm your submission by email, however we will require you to stop by your home branch to finalize paperwork.