Provider Registration Step 3

Create Account

Vendor Registration

Submit the form below to become a vendor on this store.

Important: This is the name that customers see when purchasing your products. Please choose carefully.

What to Expect Next

Once you submit the registration form, you will receive an email verification from Once your registration is approved, you will receive a second email with links to sign in to your new account and set up your practice and personal profile.

Our Get Started Guide will guide you through setting up your practice/store and adding products/services for sale.