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Physician Registration

If you are a laboratory with an established 4medica account and would like to register a new physician practice to your account, please read and agree to the following User Agreement.
You may then complete and submit the new Account Registration Form to add your new practice.

Account Registration
Please enter information about the practice. The "Practice Name" may be the name of a
physician. Additional physicians and other users may be added after the account is
established.

The red triangleindicates a required field