SignUp For ClaimX

The document below needs to be completed and returned.

We have supplied the document in Adobe PDF format.

Account Setup Instructions

 

Prior to using ClaimX you need to first have you account setup properly.  If you have not already received your paperwork for setup, there are several ways to get started.

 

You can download the form below

  or

Add the item to your shopping cart and proceed to the Checkout link above

  or

Send an email to sales@extradent.com.

 

The forms need to be filled out and returned to us in order to set up your account.  Once the forms are received we will send a setup package.  The package will contain instructions on how to schedule the install and training.

 

The completed form needs to be returned via fax directly to 866-241-8437.   If you have problems faxing, please contact Sales at 530-676-4078.

File in Adobe PDF Format:

ClaimX SignUp Forms

If needed you can download the Adobe PDF Viewer by clicking this link

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ClaimX
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Add this item to your cart and then proceed to Checkout.

Enter the required data and submit your order.

No payment is required.

When we receive the order we will email or mail the signup forms.  Please complete the forms and return via fax to the number on the signup forms.

The forms need to be filled out and returned to us in order to set up your account.

 

Once the forms are received we will mail (US Mail) a setup package.  The package will contain instructions on how to schedule the install and training.