Purchase Cliradex For Your Practice

For eye care professionals who want to purchase, stock, and sell Cliradex eyelid cleansers to their patients through their practice.

Doctor Registration

Facility Name*
Doctor’s First Name*
Doctor’s Last Name*
NPI
Doctor/Facility Email*
Doctor/Facility Phone*
Select your Facility Type
Select your MD/OD*
Select your Network Affiliation
Your Bio-Tissue Representative's Name*
Hidden
BTI STF CODE

code for each reps
Create your username*
Password*
Enter Password Confirm Password