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Physician Portal Registration

Please fill in your details below. You will receive an email once your account is reviewed and approved.

Personal details

Last name *

First name *

Email address *

Contact number *

Fax number *

Specialty (if any)

Family physician

EMR vendor

To help with future enhancements, please provide the name of your EMR vendor (if applicable).

Billing details

Billing number *

Clinic affiliation details

Are you affiliated with a clinic? *

Please review the .

I have read, understood, and accept the terms of service.

Your user ID and password are created by our team and emailed to you once your account is approved.

Please allow 5-7 business days for account creation.