Polymedco - Create an Account

It’s simple to join!

To begin the registration process for Polymedco’s Quality Control and Peer Review Program (QCPRP), please fill in the information below. You will receive an email confirming your request for registration. Your registration request will be reviewed within 24 hours, Monday through Thursday, 9:00 am to 6:00 pm EST. Please set your email application to accept emails from Polymedco. Only emails relative to the QCPRP Program will be generated.

Create New Account (fields with an (*) asterisk are required)

Account Information

Account Name*

Address*

Country*

City*

State*

Province*

Province

Postal Code*

Account Phone Number*

QCPRP Account Number

(Assigned by Polymedco)

Contact Information

First Name*

Last Name*

Title*

Contact Phone Number*

Fax Number

Email Address*

Confirm Email*

Password*

The password must contain at least one number and one letter and be at least 6 characters long.

Confirm Password*

For verification purposes please enter a recent control lot number

Recent Control Lot #*

Purchased From*

I have read the Privacy Policy and agree to the terms and conditions

Cancel

Create an Account

Please review the information you entered before submitting it.

Account Information

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Account Name	{{vm.account.Name}}
Address	{{vm.account.Address}} {{vm.account.City}}, {{vm.account.StateProvince}} {{vm.account.PostalCode}} {{vm.account.Country}}
Account Phone Number	{{vm.account.Phone}}

Contact Information

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Title	{{vm.contact.Title}}
Contact Phone Number	{{vm.contact.Phone}}
Fax Number	{{vm.contact.Fax}}
Email Address	{{vm.contact.Email}}

Recent Control Lot #	{{vm.other.ControlLotNumber}}
Purchased From	{{vm.other.PurchasedFrom}}

Thank you. The account registration has been submitted. Please allow up to 24 hours for account activation. Once the account is active, a confirmation email will be forwarded to the email address registered.