Start e-Prescribing Today

Complete the registration form below to begin your enrollment.

Prescribe On The Go

EPCS Class II–V, compound, DME and supplies from any mobile device. Desktop, tablet, or smartphone.

Insurance Formulary Check

Verify prescribed medications are covered by insurance prior to transmitting. See co-pay amounts and formulary alternatives in real time.

Patient Eligibility

Instantly verify patient eligibility details for prescribed medications at the point of care, reducing callbacks and rejections.

$46.90 / month per provider, up to 500 scripts · $79.00 / month, 501–850 scripts

One-time: $25 account setup + $60 Surescripts® Provider ID Verification · 851+ scripts? Contact us for bulk pricing

Registration Form

e-Prescribe Registration

Provider Information

First Name *

Last Name *

Email Address *

Business Phone *

Fax Number

Mobile Phone

Provider Credentials

NPI Number *

DEA Number

State Medical License

Practice Name

Practice Information

Which EMR/EHR do you currently use?

Estimated Prescriptions per Month

Do you prescribe from more than one location?

Physical Practice Location *

Website Address

Preferred Start Date *

Pricing: $46.90/month per provider (up to 500 scripts) · $79.00/month (501–850 scripts). One-time fees: $25 setup + $60 Surescripts® Provider ID Verification. Contact us for 851+ bulk pricing.

A member of our team will contact you within 1–2 business days to complete setup. For immediate help, call 954-237-3700.

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Surescripts® Certified

Certified on the national pharmacy network

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EPCS Certified

Class II–V controlled substances, DEA compliant

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Mobile-Friendly

Prescribe from desktop, tablet, or smartphone

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Real Human Support

24/7 support. Call 954-237-3700