Medbiz Medical Supplies and Office Supplies

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NOTICE

If you are using INTERNET EXPLORER VERSION 7.0 or newer, you must follow these instructions before registering, or you will be unable to logon to your account. Instructions: Open the Internet Explorer browser; Click on the Tools button (near top right of the browser window); Select the Internet Options link (at the bottom); Select the Advanced tab (at the far right); Scroll all the way down; Uncheck the 'Use TLS 1.0' box; Click the OK button. Please contact our Customer Service Team if you need more assistance.

Registering as a Medbiz member is absolutely free, and the process is quick and easy. We ask that you read our Terms and Conditions and Privacy Policy before registering. By registering, you are agreeing to our terms and conditions.

• All fields highlighted in yellow are required.
• Move mouse cursor to the green note to view further instructions.
• To advance to the next field, press the tab key.

OFFICE CONTACT

Salutation
First Name
Last Name
Job Title
Telephone
Fax
Email Address
Method of Contact	note

BUSINESS INFO

Business Name
Billing Street
Building/Floor/Suite
Billing City
Billing State
Billing Zip
Shipping = Billing	note
Shipping Street
Building/Floor/Suite
Shipping City
Shipping State
Shipping Zip
Practice
Specialty
Frequency of Ordering	note
Monthly Average	note
Number of Offices
Number of Doctors

LICENSE INFO

The license information must be filled in correctly to purchase any items requiring a DEA license. Your order will be delayed if the information provided is incorrect.

First Name
Last Name
State
Medical License Number
License Expiration
DEA License Number	note
DEA License Expiration

Username	note
Password	note
Confirm Password
Security Question	note
Security Answer	note

ADDITIONAL INFO

Referral	note
Referral Code	note
Email Specials	note

Please click the 'SUBMIT' button to finish the registration process.

| toll-free: 888.827.5477 | fax: 360.923.0600