Skip to content
Learn more about the ERC program
Learn more about the ERC program
Join MedResults
About
Vendor Partners
All Vendor Partners
Empire Medical Training
The Medical Business Academy
Webinars
Upcoming Webinars & Events
Business Webinars
Clinical Webinars
MRN Blog
Contact
Menu
About
Vendor Partners
All Vendor Partners
Empire Medical Training
The Medical Business Academy
Webinars
Upcoming Webinars & Events
Business Webinars
Clinical Webinars
MRN Blog
Contact
Join MedResults Network
Find Out How Much You Can Save
Membership is FREE
Enroll now with no obligation or long-term commitment!
Company Name
*
Phone Number
*
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Website
Are You The Primary Contact For Your Practice?
*
Yes
No
Your Name
*
First
Last
Primary Contact Name
*
First
Last
Primary Contact Email
*
Hidden
Affiliated Physician
*
Medical Director Name
*
Dr.
Nurse
Prefix
First
Last
Medical Director's Email
*
How Did You Hear About Us?
*
Vendor Partner / Vendor Sales Rep
Direct Mail
Email
Event or Conference
Friend or Colleague
MedResults Network Representative
MRN Skin Store
Other
If referred by "Other", please help us to be more specific.
Empire Medical Training Event
Live Conference / Industry Seminar
Vendor-Hosted Webinar
Referring Vendor Partner?
*
Merz Aesthetics
Empire Medical Training
Sientra / BIOCORNEUM
Suneva / Bellafill
HUB International
PurchaseClinic
Cardinal Health
Members Only Processing
EVO
Other
Your Referring Friend/Colleague
Would you like to opt-into Staples Advantage for discounted pricing on all of your office supplies?
*
*If you select yes, you'll have access to complete the creation of your Staples Advantage account below. This will provide you access to the Staples Advantage site where you can purchase discounted office supplies at no additional cost to you. Through your membership, you'll also have access to free overnight shipping and added discounts and cash back on many of your Staples purchases!
Yes
No
Would you like access to our discounted GPO pricing for your medical/surgical supplies?
*
*Like MedResults, there is no cost for enrollment.
Yes
No
Members are saving up to 40% on their shipping through FedEx. Do you want to receive this discount on your shipping?
Yes
No
You and your employees can utilize our partner's Enterprise, National and Alamo rental car contracts for savings on Business and Leisure travel. Are you interested?
Yes
No
Who is your primary medical supply distributor?
*
McKesson/PSS
Henry Schein
Cardinal
Medline
Moore Medical
I don't know
Please indicate any other medical/surgical supply distributors you work with:
McKesson/PSS
Henry Schein
Cardinal
Medline
Moore Medical
What is your class of trade?
*
Clinic
Ambulatory Surgery Center
Since you chose "Ambulatory Surgery Center" as your class of trade, let us know if this sounds like you:
Many suppliers only recognize Surgery Centers if they meet the following requirements. * Have a sterile Operating Room * Use general anesthesia * Have a recovery room
Yes
No
Do you currently purchase your sutures through your distributor?
Yes
No
I don't know
Do you have an onsite OR (Operating Room)?
*
Yes
No
How many onsite ORs (Operating Rooms) do you have?
*
1
2
3
4
5
6
7
8
9
10 or more
Select the following products or services on which you would like to receive savings (Through our partners in these categories, our members experience the greatest savings).
Select All
Med Mal Insurance and/or General Liability
Medical Supplies (In-Office)
Medical/Surgical Supplies (For Practices With Onsite ORs)
Injectable Fillers (Belotero or Radiesse)
Injectable Filler (Bellafill)
Medical-Grade Skincare (SkinMedica or Others)
Facial Rejuvenation Devices
Compounded Medications
PDO Threads
Merchant Processing
Patient Financing
Medical Education or Training
Marketing Services & Applications
EMR / EHR Software
Others
MedResults Network Terms & Conditions
*
To confirm, MedResults Network is a buying network of aesthetic physicians and medical spas. Your membership is entirely free. There is no obligation to purchase and no change in the way that you purchase or pay for products and/or services. You may opt out of membership at any time. Simply advise the participating vendors that you are a member. Vendor and/or client references available on request. Any MedResults Network member participating in the MedResults Network rebate program will not seek federal, state, or local healthcare reimbursement (e.g. Medicare, Medicaid, VA or otherwise) for any products for which it receives a rebate nor may any of the Merz products be resold other than to a client or patient. For questions, comments, or suggestions contact MedResults Network at info@medresultsnetwork.com Attn: Jamie Parrott or call (844) 799-2384. To fax this form to MedResults Network, please dial (562) 391-4407.
I Agree to the Terms & Conditions
Hidden
Create Your Online Account
Your online account is used to access member-only content areas of MedResultsNetwork.com. When logged in, you'll be able to view Vendor Discounts, Contact Vendors, and more.
Human Verification
Name
This field is for validation purposes and should be left unchanged.
