Register Your Practice, Facility or Service
Participation on Health Bid Network requires a $200.00 Dollar Annual Fee for the First Physician or Practitioner in your office.
Additional Providers at one office are $100.00 dollars per year.
For Inpatient Facilities, we charge $100.00 Dollars Per Bed Per Year.
Login Information
   Red = Required
    
   Email/Login:                 
   Password:   
   Security Question:   
   Security Answer:   
Provider Information
   Business Name:    
   Display Name:     
   Country:  
   Primary Language:    (For office staff)  
   Secondary Language:  
   Address 1:   
   Address 2:    
   City:   
   State:     County: 
    Zip/Postal Code:     
   Main  Phone:      
   Fax:                       
   Other Number:               
   Web Site:  
Contact
Primary Contact Secondary Contact
Name:   Name:
Title: Title:
Phone:
Phone:
Cell Phone: Cell Phone:
Email:   Email:
Billing Address
Is Billing Address the same as the Business Address?
                                
   Name:   Phone:     
   Address1:   Country:
   Address2: State:
   City:   Zip/Postal Code:  
Category
Please choose a Category that best describes your business from the list of Categories.
      Select Category:    . . .
       
    Select Mobile Category:         Mobile Category?
Bussiness Description

Enter an initial description of your business or services.
Note: Inserting spaces and blank lines will help readability.

 

You can add more comprehensive text on your "My Business Account" page at a later date.
Keywords
Enter Keywords that describe your Business or Services.
You can add additional Keywords on your "My Business Account" page at a later date.
Consumer Information
Select "A" for By Appointment, "H" for Hours, or "Blank" for no hours

Hours will be displayed exactly as your enter them.
hh:mm am or hh:mm pm is recommended

DAY OPEN CLOSE
Sunday
Monday
Tuesday
Wedsnesday
Thursday
Friday
Saturday


Questions
Are you a Non Profit Organization (Your listing may be free)? (Enter Y/N)
Would you like consumers to be able to send you messages directly to your email? (Enter Y/N)
How did you sign up for our site?
Were you referred to healthbidnetwork.com? (Please enter their Full Name)
Bid Criteria
Receive notice of new Cases by              
Include Cases with              
We Accept                                           
International Patients           

If the patient is more then 100 miles away, will you provide assistance or reimbursement for any of the following:
               
Calculate Your Annual Fee
             
Number of Practitioners or Inpatient Beds:                   
Amount Due:                                                                

Amounts up to $1000.00 Dollars may be paid by Credit Card or via an invoice received in the mail.
Amounts over $1000.00 Dollars must be paid via Invoice.
Your Practice will not be set as Active until payment is received and processed in full.
Health Bid Network does not store your credit card information on our servers at any time.
By checking the box you agree to the Health Bid Network  Terms of Use  Agreement