Telemedicine Account Request

Telemedicine Inquiry

  • This page is intended for prescribing physicians only. If you are a patient and have questions, please contact an ImprimisRx customer care representative toll-free at (844) 446-6979.

    Thank you for your interest in setting up your telemedicine account with ImprimisRx in partnership with Doxy.me. Please fill out the information below. If you are an existing or a new ImprimisRx customer, we will set you up and get you ready-to-go within 24 hours.
  • Prescriber Name
  • Email Address (DO NOT USE THE SAME EMAIL FOR MULTIPLE DOCTORS. AN INDIVIDUAL EMAIL IS NEEDED TO SIGN UP EACH DOCTOR'S ACCOUNT)
  • Specialty
  • NPI Number
  • Don't know your NPI Number? Click here to look up your NPI number.
  • Facility Name
  • Facility Address
  • Cell Phone Number
  • Facility Contact Name
  • Are you an existing ImprimisRx customer?
  • What EMR system do you use?