Account Application.

Each of our accounts gets personalized service by an experienced account executive who is available by phone, fax, or email.
  1. Fax over a copy of your state Pharmacy License to 1-888-000-0000.
  2. Please print our New Account Application Form and return to bTechRx via fax or mail.

Once your application is approved, you will be able to place your order that same day! Please don't hesitate to call or email any of our qualified representatives who are ready to assist you.

Note: We also accept Visa, MasterCard and American Express.

TERMS & CONDITIONS: By applying for credit you acknowledge responsibility for payment by both your corporation, if any and yourself individually. Unless otherwise stated in writing, all invoices dated 1st through the 25th, of any month are due and payable on or before the 10th of the next month following the month of purchase. Invoices dated 26th through the 31st, inclusive, are due and payable on the 25th of the next month following the month of purchase. In case of default, you agree to all reasonable collection and/or attorney fees. The above information is herewith submitted for the purposes of opening an account, and you do certify this information to be true.

Contact information


Company Address
City, State ZipCode


Office:   888-000-0000


General Information:
Sales Information:
Human Resources:

Newsletter Sign Up.

Get in touch with us.

Company Name
Company Full Address
City, State ZipCode


Phone: 888-000-0000