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  1. Determine the medications you would like to dispense on the medications most prescribed in your office. Please provide us medication name, strength, and size on the Medication Price Request Form (click do download) or provide us with your established formulary. Prices will be based on your medication requirements.

  2. Please fill out our Practice Information Form (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 New Account Packet (click to download) per Federal DEA requirements.

  4. Photocopies of your DEA, State and applicable, your State Dispensing Licenses, are required


Fax all documents to: 1-800-563-6967 - OR - eMail to:


Upon receipt of all completed documentation, an Aidarex Representative will contact you within 24 hours to walk you through the next steps to establish your account and ship your first order.


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