Create an Account And start shopping today "*" indicates required fields Step 1 of 8 12% We know managing our health through diet and nutrition can often be confusing, time-consuming, and expensive. That's why we built Attane Health - a place you can easily shop, learn, and connect with others - all in one place.First Name*Last Name*Enter your 10-digit Invite Code:*You can find your invite code in your welcome email. Include hyphens when entering the code.State* Select your StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Your Login Create a strong password. If you don't have an email address you'll be able to login with your mobile phone.Email* Mobile PhonePassword* Enter Password Verify Password Strength indicator Minimum of 10 characters long and contain at least one uppercase and one lowercase letter (A,z), one numeric character (0-9), and one special character (such as !, %, @, or #) Date of Birth*Gender*Enter your genderFemaleMaleNon-binaryOtherWhat is your race?*Select all that apply American Indian or Alaska Native Asian Indian Black Chinese Filipino Guamanian or Chamorro Hispanic Japanese Korean Native Hawaiian Other Asian Samoan Other Pacific Islander Vietnamese White Other Other Race* Do you have any food allergies or intolerances?*Select all that apply Egg Fish Milk / Dairy Peanut Sesame Shellfish (e.g., shrimp, crab, lobster) Soy Tree Nut (e.g., almonds, cashew, hazelnut) Wheat Other No food allergies or intolerances Other Allergy or Intolerance*Do you have any existing health conditions?*Select all that apply None Hypertension (high blood pressure) Eczema Cancer Crohn’s Disease Celiac Disease Diabetes - Type 1 Diabetes - Type 2 Gastrointestinal Disease Heart Disease Kidney Disease Sickle Cell Disease Asthma Thyroid Disorders Other Other Health Condition Do any of the following dietary preferences or restrictions apply to you based on your religion or cultural background?*Check all that apply Vegetarian Vegan Halal Kosher Gluten-free Lactose intolerant Other N/A Other dietary preferences or restrictionsHow would you describe your current nutrition knowledge?* Very low Low Moderate High Very High Tell us about your household The following questions ask about your household. For these questions, your household includes you and anyone else who lives with you in your place of residence (e.g. home, apartment). This includes your spouse, any other family members, or roommates. How many Adults currently live in your household?*Adults 18+ yearsEnter a number012345678910How many Children currently live in your household?*Children 0-17 yearsEnter a number012345678910Which language(s) do you speak?*Select all that apply English Spanish Chinese (e.g., Mandarin, Cantonese) Tagalog Vietnamese French Arabic Korean Russian Other Other Language Over the past 12 months, how many times did you utilize an emergency food provider (e.g., a food pantry)?* Never 1-5 times 6-10 times 11 or more times Within the past 12 months we worried whether our food would run out before we got money to buy more.* Often True Sometimes True Never True Within the past 12 months the food we bought just didn’t last and we didn’t have money to get more.* Often True Sometimes True Never True Are you physically active (exercise, walking, etc) 3 times a week or more to improve your health?* Often True Sometimes True Never True How do you prefer to receive updates and information from us?* Email SMS/Text Messages Phone Calls Social Media Website/App Notifications Postal Mail How did you hear about the program?* SMS/Text Messages Social Media Case Manager Friend/Family Member Consent* I agree to receive SMS text notificationsBy submitting this form, you agree to receive SMS updates on your order status and reminders from Attane Health. Msg&data rates may apply. You can opt-out at any time by replying "STOP". For assistance, reply "HELP". Your information will be handled in accordance with our Privacy Policy.
