Register Now

You can register by contacting us via email, telephone or by completing the Application Form and sending it to us.

For your convenience, the MediDirect PDF Application is fillable and savable using the free Adobe Reader, provided you download to your computer prior to use. If you simply click on the Application, the linked document will open in your internet browser and functionality is not supported. Filling and saving PDF forms

  1. Right mouse click on the form name. Depending on your internet browser, you will choose "save target as" or "save link as".
  2. Save the PDF fillable/savable form in a folder that you will easily find on your computer.
  3. Launch Adobe Reader.
  4. Browse to the folder where you saved the file, and open it from within Adobe Reader. You can now fill and save your PDF form.

MediDirect® Application (pdf)