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Physician Signup

Physician Side

Physicians, looking for new products to help your patients? AminoPharmaceuticals has launched a supportive campaign for physicians to sell our products at bulk discounted rates.

Sign up with our program by filling out the form below.

Once you’ve completed the form, We will perform a quick background check to verify your credentials and you’ll be able to login directly to to your physician portal.

  • Basic Information

  • If you have a website for your own practice, please tell us about it.
  • Account Login Information

    Type in your username and password. This is only used to log you in to your Physician's Portal. Please keep this information for your record.
  • Enter a username that you will use to log in to your Physician's Portal.
  • Strength indicator
    Please ensure your password is strong. You can use characters between A-Z, 1-9, and special characters such as !, @, and #.
  • Physician and Clinic Information

  • If there is anything you would like to share with us in addition to the information above, please let us know here.
  • Signed Agreement

  • This field is for validation purposes and should be left unchanged.