Doctor Account Registration

Online Account Registration For Doctors
  • Contact Info

  • Enter a username. (Min. 8 alphanumeric, lowercase chars. only).
  • Enter a password for your online account. (Min. 8 chars., incl. uppercase, lowercase, numbers).
    Strength indicator
  • Account Payment

  • Enter an account type
  • Enter a payment method.
  • For payment terms, download Credit Application*, fill and submit below.
  • Education

  • If healthcare student, enter educational institution.
  • Communication

  • Your patients purchase our products directly online using your AlphaScienceLabs referral code. Program not applicable to HealthCare Students.
  • This field is for validation purposes and should be left unchanged.