RapidRead Activation Form

"*" indicates required fields

I'm interested in activating:*

RapidRead Radiology

RapidRead Dental (waitlist)

RapidRead pre-op ECG (waitlist)

Name*

First Last

Role*

Veterinarian

Practice Owner

Practice Manager

Technician

Other

Phone Number*

Email Address*

Practice Name*

ANTECH or AIS Account Number

Practice Phone Number

Extension

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Phone

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