Member Contact Info Update Form

If you want to add new employees to our database to get client alerts, newsletters, etc., or if other information about your business, such as your clinic address, has changed, please fill out the form below.

Practice Management Network Membership Renewal

  • Changes to Practice Manager Information

    Please fill out the name and email of your Practice/Office Manager if changed.
  • Billing Manager (or Third Party Billing Company)

  • Changes to Member Distribution List

    Please list any new personnel you want us to ADD to our member distribution database to receive email notices/alerts
  • Changes to Member Distribution List

    Please list any personnel you want us to REMOVE from our member distribution database to receive email notices/alerts, i.e. office staff who no longer work for you but were in our member database previously