How to Apply

Ready to join?

Start by telling us a little bit about your practice and we’ll get right back to you with more information, including an application, a short group purchasing agreement, and a confidential price list.







    About Your Practice

    Practice Name*

    Practice Type*

    Number of Physicians*

    Primary Contact Information

    First Name*

    Last Name*

    Your Email*

    Practice Address*

    Phone Number*