IDOC Select Enrollment

Practice Information:

*Practice Name

*Street Address

Address Line 2

* Does this practice have more than one location?      Yes      No

Primary OD:

*Secure Email
By providing the above e-mail address (the “Secure Email”), the member, listed above, (“Member”), consents to IDOC, LLC, a Connecticut limited liability company (“IDOC”), sending potentially sensitive and confidential practice related information of Member, including, without limitation, financial information (i.e., revenue figures, sales numbers, accounts receivable collection rates, rebates received, etc.) to the Secure Email without encryption. Member is solely responsible for safeguarding the username and password for the Secure Email to prevent unauthorized access to information sent to the Secure Email. Member acknowledges that internet communications, including e-mail, are not completely secure, and it is possible that a third party could gain access to such communications. The provision by IDOC of information or recommendations to Member is subject to the IDOC Membership General Terms and Conditions in effect from time to time, which are available on IDOC’s website.

Create A Password:

You will use the primary contact email address and this password to log into the IDOC website.
Passwords should be at least 6 characters and have at least one uppercase letter, lowercase letter, number and special character. For example: DontUseThis1!