1. Determine the medications you would like to dispense based on the medications most prescribed in your office. Provide Medication Name, Strength, and Size on the Dr. Medication Price Request Form (click to download) or provide us with your established formulary. Prices will be based on your medication requirements.
2. Please fill out our Account Qualifying Sheet (click to download). This short form provides us with important information about your practice so we can suggest the best programs and services to complement your practice specialty and patient demographics.
3. Please fill out our Practice Profile Form (click to download) per Federal DEA requirements.
4. Please fill out our Credit Application (click to download).
5. Photocopies of your DEA, state,, and if applicable, your state dispensing licenses, are required.

FAX all documents to 1-800-563-6967

Once Aidarex receives this information and sets up your account, within 4-7 days your first order will be delivered. Subsequent orders will only take 2-3 business days.

Download this page with a handy check list for reference. Download the forms mentioned above as one package.