Apply

Apply for Ternary Passport.

Passport is a research-intelligence retainer for a household with two members navigating complex cases. Please share information about both members below.

What you’ll provide if accepted

Every accepted client provides the same standardized inputs — see the Ternary Core Dataset for the full schema. Nothing on this page asks for medical records; the Core Dataset is gathered securely after acceptance.

Passport application — two household members

Passport covers up to two adults in one household with ongoing research support. Please share information about both members below. If only one member currently has a case, Passport may not be the right fit yet — consider starting with a Precision Deep Dive and upgrading later.

Section 01

Household applicant

The primary contact for this engagement. Can be either member or someone authorized to apply on behalf of the household.

First name *

Last name *

Email *

Phone

City, country *

Relationship between members *

Section 02

Household member — A

The first member. Keep the situation summary high-level. Records are shared later, through a secure intake flow.

First name *

Age range

Primary condition or problem *

Short situation summary *Do not paste medical records. Full intake happens after engagement.

Section 03

Household member — B

The second member. Same structure as above.

First name *

Age range

Primary condition or problem *

Short situation summary *

Section 04

What you're hoping for

Applies to the household — what would make a Passport engagement worth it?

Goals (select all that apply to either or both members)

Section 05

Resources on hand

Across both members. Nothing is required.

Which of the following are available?

Section 06

Logistics

Final practical details. A fit call is free and takes about 30 minutes.

Preferred contact method

Preferred timezone for a fit call

Anything else we should know?

How did you hear about Ternary Health?

Before you submit

The information you submit here is transmitted over TLS/HTTPS and routed only to our principals. We do not deploy web analytics, session replay, or advertising tracking on this site. Our full data practices are described in our Privacy Policy and Security & Data Practices.

I understand that Ternary Health is a planning and research service, not a medical practice, and does not diagnose, prescribe, or replace my physicians. I acknowledge that this application contains a limited amount of health-related information, which will be used only to evaluate fit and, if accepted, to coordinate the engagement. I have read, or have had the opportunity to read, the Privacy Policy and Security & Data Practices linked above.