New Account Application

Qualified health practitioners are welcome to register through the Biomed website, or download an application form PDF here. Once approved, an email will be sent to you with confirmation and your user login and password.

Not ready to apply for an account? Click here to arrange a consultation with one of our Education and Medical Support Specialists.

Contact information

Billing and Mailing Address:

Shipping Address (if different from billing information)

Example: (123)-456-7890



Credit Card Authorization *


Practitioner Certification Or Student ID
Certification of Student ID

Please upload your certification or student ID here. Alternatively you can email it to



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Internet resellers must have a valid Minimum Advertised Price Agreement in place.

Do you plan to resell our products online? *