Register for an Account

Creating an account will allow you to purchase both ECS Therapeutics and Patient One MediNutritionals professional brands. You will have the ability to easily toggle between the two company websites with one log-in; however, orders will need to be placed separately. Combined shopping cart experience is coming soon.


Practitioner Name:
Professional Designation:
Healthcare Specialty:

Email Address:  
Required for billing and order tracking purposes.
Create Password:
Re-enter Password:
 
Account Type:
Name of Practice: (full legal name)
Address:
City:
State:
Zip Code:
Practice Phone #:
 
License/Certificate #: State
OR
Federal Tax ID #:
 
Practice Website: (if applicable)
 


Please name the 3 most common conditions you treat:
Which brands do you currently use in your practice?
How did you hear of us?
Who can we thank for your referral?


 
Add an Account Code
(if applicable)
Notes

   required fields