ACXSS Email Marketing -

ACXSS Enrollment Form

Welcome to ACXSS! Your affordable cloud-based supply chain management solution that automates the purchasing process, manages your inventory and captures total spend by utilizing our AI-powered Procure-to-Pay application.

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Practice Name *

Name of Authorized Doctor *

Specialty *

Authorized Business Contact *

Street Address *

Address 2

City *

State *

Zip Code *

Email *

Phone Number *

# of Locations *

Please provide your account number for the following vendors (if applicable):

McKesson (Medical Supplies) Bill To ACCT #:

McKesson (Medical Supplies) Ship To ACCT #:

McKesson Rep Email:

Henry Schein (Medical Supplies) Bill To ACCT #:

Henry Schein (Medical Supplies) Ship To ACCT #:

Henry Schein Rep Email:

Office Depot (Office Supplies) Bill To ACCT #:

Office Depot (Office Supplies) Ship To ACCT #:

Office Depot Rep Email:

Staples (Office Supplies) Bill to ACCT #:

Staples (Office Supplies) Ship to ACCT #:

Staples Rep Email:

CLIA Waived (Lab Supplies) ACCT #:

CLIA Rep Email:

Please link my practice to the following discounted vaccine contracts:

Glaxo Smith Kline (GSK) ACCT #:

Merck Vaccines ACCT #:

Pfizer Vaccines ACCT #:

Sanofi-Pasteur Vaccines ACCT #:

Moderna (Covid Vaccine) ACCT #:

Seqirus (Flu Vaccine) ACCT #:

AstraZeneca/Flumist (Vaccines):

Yes

Read the ACXSS and ABS Participation Agreement Terms:

Read our ACXSS Participation Agreement and our ABS Participation Agreement

By submitting your application you agree to the Participation Agreement terms

Yes *

Please verify your request. *

📩 IMPORTANT — PLEASE READ BEFORE JOINING

To complete your ACXSS enrollment, you will need to confirm your email after clicking "Join Now."

Your enrollment is not complete until you click the link to confirm that email.

The confirmation email will come from:
arosato@acxss.com

If you do not see the email:
Check your Spam, Promotions, or Junk folder
Or search your inbox for: “TPC”