Please enter the following information, which is used to configure your system.
Last Name, First Name, Email, Office Name, Office Phone and Address information should be the same information you will eventually use to register the software.
If your office management software does not yet integrate with SteriRecall, a database can be populated, using your patient list, to get you started. We will provide you with a Confidentiality Commitment Agreement. If you are comfortable attaching a patient list, please do so. If not, please consider forwarding an encrypted link through CDAnet to firstname.lastname@example.org