WELCOME

We received your request to open an account with Tailor Made Health.

Thank you for the opportunity to assist you with your compounding needs.

*Please follow the five simple steps to set up your account.

CLINIC INFORMATION

Clinic Name:
Address:
City:
State:
Zip Code:
 

OFFICE CONTACT INFORMATION

Best Office Contact Name:
Contact's Position:
Email:
Practice User Name:
Practice Password:
Confirm Password:
Clinic Phone:
Fax: