| Security Code: |
In order to create a facility account, a security code issued by Vendor Credentials is required. For security reasons, this will be issued directly to the facility by a Vendor Credentials representative. |
| Login: |
Unique login that allows access to account information. |
| Password: |
Password must be 5-20 unique alphanumeric characters. |
| Medical Group: |
The medical group to which the facility belongs, if applicable. |
| Name: |
The name of the specific facility represented by this account. |
| Type: |
A general description of the facility's purpose. |
| Upload Facility Logo: |
To up load a new logo file, use the Browse feature and select your file. It will be saved to your account. Please note that the image saved here will be displayed on vendor badges. Accepted formats are .jpg, .bmp, and .gif. |
| Doctor Login: |
Unique doctor login that allows access to doctor appointments. |
| Doctor Password: |
Password must be 5-20 unique alphanumeric characters. |
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| First Name: |
The first name of the person who is the contact for facility. |
| Last
Name: |
The last name of the person who is the contact for facility. |
| Phone: |
The preferred contact phone number for the person listed as the primary contact. |
| Email: |
A valid email contact address for the contact person. This will be the primary means of communication, so please keep it current and provide an address that is regularly monitored. |
| Best Contact Time: |
The general time of day that is most convenient for you should Vendor Credentials need to contact you by phone or visit. |
| Current Logo: |
A view of the current logo associated with your account. The image viewed here will be displayed on vendor badges. Accepted formats are .jpg, .bmp, and .gif. |
| Facility Website: |
The website for the facility. Please enter the website address most specific to your location. Please use the www.domain.com format. No 'http:' prefix is required. |
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