Thank you for Registering for an account to the Allergen Extract Lab Management System.
In order for your account to be approved we will need your current curriculum vitae and a signature card. This information can be faxed to us at XXX-XXX-XXXX. Only board certified (American Board of Allergy and Immunology) and board eligible physicians are authorized to initiate therapy for allergen extract vaccines. New prescriptions written by a non-board certified physician must be reviewed and cosigned by a regional Allergist. For refill prescriptions, attending and clinic directing physicians (non-Allergists) are authorized to prescribe for continued therapy.
Please fill out the account request form below. Your new account information will be emailed to you if your account is approved.
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Please review the following terms and indicate your agreement below.
This is a Federal Interest Automated System protected by Federal Law and may be accessed and used by authorized personnel only. Anyone using this system is advised that any evidence of unauthorized or criminal activity will be provided to the appropriate authorities. The information in this system is protected by the Privacy Act of 1974 (PL-93-579). Unauthorized access to or use of this system is a violation of Federal Law. Violators will be prosecuted.
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