First Name*

Last Name*

Type* - Select Type - Physician Dentist Pharmacist

NPI*

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State License Number*

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DEA Number*

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Cell Phone*

Email*

This will be your login.

Password*

Confirm Password*

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Name of Practice*

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Address*

Address1

City*

State* - Select State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming * District of Columbia Puerto Rico Guam American Samoa U.S. Virgin Islands Northern Mariana Islands

Zip*

Telephone

Term and Conditions These Terms and Conditions of Use (the "Terms of Use") apply to the Micro Prescription web site located at www.microprescription.com, and all associated sites and applications linked to www.microprescription.com by Micro Prescription, its subsidiaries and affiliates, including macrodx.com sites around the world (collectively, the "Site"). The Site is the property of Micro Prescription. ("MicroPrescription.com") and its licensors. BY USING THE SITE, YOU AGREE TO THESE TERMS OF USE; IF YOU DO NOT AGREE, DO NOT USE THE SITE. MacroDX reserves the right, at its sole discretion, to change, modify, add or remove portions of these Terms of Use, at any time. It is your responsibility to check these Terms of Use periodically for changes. Your continued use of the Site following the posting of changes will mean that you accept and agree to the changes. As long as you comply with these Terms of Use, MicroPrescription.com grants you a personal, non-exclusive, non-transferable, limited privilege to enter and use the Site.To be eligible for our Services, you must be at least 18 years old and a resident of the United States or one of the countries listed. This Agreement applies only to Users who are residents of the United States. If you are a resident of another country, you may access your agreement from our website in your country (if applicable).MicroPrescription.com provide product registration services. MicroPrescription.com is an independent contractor for all purposes, except that MicroPrescription.com acts as your agent with respect to the registration of your product or service only. MicroPrescription.com does not have control of or liability for the products or services that are registered with our Service. We do not guarantee the identity of any User or ensure that a registered product are valid.You authorize MicroPrescription.com, directly or through third parties, to make any inquiries we consider necessary to validate your identity or validity of registered products or services. This may include asking you for further information, requiring you to take steps to confirm ownership of your email address or financial instruments, ordering a credit report and verifying your Information against third party databases or through other sources.We may, at our discretion, impose limits on the registration of your products and services on our site. We may also have right to modify or remove your registration of your products and services on our site.When you register a product or service, you are providing an Authorization to the other user to use the register number to identify your product.You are responsible for all Reversals, Chargebacks, Claims, fees, fines, penalties and other liability incurred by MicroPrescription.com, a MicroPrescription.com User, or a third party caused by or arising out of your breach of this Agreement, and/or your use of the Services. You agree to reimburse MicroPrescription.com, a User, or a third party for any and all such liability.You will receive a password and account designation upon completing the MicroPrescription.com registration process. You are responsible for maintaining the confidentiality of the password and account and are fully responsible for all activities that occur under your password or account. You agree to (a) immediately notify MicroPrescription.com! of any unauthorized use of your password or account or any other breach of security, and (b) ensure that you exit from your account at the end of each session. MicroPrescription.com! cannot and will not be liable for any loss or damage arising from your failure to comply with this.

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