Once you select "Submit" below, your online account will be verified and approved within 24 hours so you can begin shopping. If you are a new member or do not have a current Patient Verification on file with us, you will need to submit or complete the additional Patient Verification* form. Failure to do so will result in registration delays.

We will contact you with any questions or additional information we require. If we experience trouble verifying your information, we will contact you and let you know as soon as possible.