Practitioner Registration

International Practitioners:
This Registration form is for United States based practitioners. Please use our International Registration form if your practice is located outside of the United States.

Practice Details

Practice Address
Practice Contact
Practice Tax Classification
Tax Exempt Example: An IRS approved organization that is a non-profit health organization, University, etc. Out of State Businesses is not located in the state of Arizona.
In State Reseller If you are an Arizona based reseller please upload your reseller certificate. If no reseller certificate is uploaded into your profile prior to the submission of an order Arizona Sales Tax will be collected. In State Taxable For practitioners who do not resell product but purchase for personal use, Sales Tax is collected.
Supporting Documents (if we are NOT to collect tax)
Upload Document