Practice Setting
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Please check this box to verify that you are a health care decision maker.
- FormularyDecisions restricts entry to those individuals who are actively working in a capacity where health care, formulary, and/or benefit design decisions are a part of their role.
- A few examples of eligible users may include: P&T Committee members, clinical pharmacists responsible for reviewing medications or managing formularies, and individuals who develop, implement, or advise health plans on various benefit design techniques.
- Representatives from other industries, e.g., pharmaceutical, biotechnology, and medical device manufacturers, are not eligible for registration with FormularyDecisions.
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If you have any concerns or questions, please contact us at
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All information is required to complete your registration.
Your privacy is important to us! To learn more, please see our Privacy Policy. |
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Company Information
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Company: |
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Organization Covered Lives: |
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Organization Geographical Coverage (i.e. State): |
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User Information
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User id (email address): |
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Using your employer-provided email address for registration helps us ensure
that Registered Users are, in fact, health care decision makers.
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First Name: |
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Last Name: |
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Role: Select all that apply |
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Position: |
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Business Title: |
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Covered Lives That You (and / or Your Team) are Responsible for: |
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Geographical Coverage That You (and / or Your Team) are Responsible for (i.e. State): |
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Line of Business: |
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Address: |
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City: |
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State: |
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Country: |
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ZIP Code: |
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Phone: |
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Professional Details
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As part of the registration process, please describe your direct involvement in making formulary and/or benefit design decisions. Please note: If you are a health care decision maker, but do not hold a professional license (as required below), you may still describe your position as a decision maker and your request for registration will be considered during the verification process. Thank you!
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Professional Degree: Select all that apply |
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Professional License: |
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Name on License: |
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State of License: |
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State License #: |
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License Expiration Date: |
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Please describe your direct involvement in making formulary and/or benefit design decisions:
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Verifying your status as a health care decision maker will be required in order for you to access select content and services.
Your professional information will only be used for verification purposes. |
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