Account Setup

  • If you have any questions, click here to read the FAQ for Doctors.
    Feel free to call us and one of our dedicated account representatives will be available to assist you today.


  • Basic Information

  • Billing Information

    (If different from above)
  • Shipping Information

  • Physician Information

  • Failure to apply license and DEA information at this time may only delay your approval process.
  • Drop files here or
    Accepted file types: pdf, jpg, png, gif.
    Please upload a copy of your DEA issued license.
    Note: Maximum upload file size: 5 MB
  • Drop files here or
    Accepted file types: pdf, jpg, png, gif.
    Please upload a copy of your State issued license.
    Note: Maximum upload file size: 5 MB
  • Payment Information (optional)

  • The person signing this application, Terms & Conditions form warrants that the above information is complete and accurate and hereby agrees to the following terms and conditions.

    It is fully agreed and understood by the client/patient that all drugs are NON-returnable or refundable under any circumstances under both Federal and/or State laws. It is unlawful for any pharmacy to accept the return of prescription medications once they have left the control of the pharmacy.

    1. The undersigning agrees to immediately notify Absolute Pharmacy if any change in ownership, form, or business name of the entity,
    2. This document will be sent as effective in photocopy, scan or fax form as in the original
    3. RETURN OF DAMAGED GOODS POLICY: Immediately upon receipt inspect contents of your package. Any missing items or damaged products must be reported within 24 hours of receiving the package. Replacement will be sent after a claims process is complete.
    4. The undersigned warrants that they have full authority to sign this agreement and obligate the entity hereunder.