Are you PGx Ready?

Please upload the following information to be considered as a PGxAlly pharmacist. This is for initial verification purposes only, and we will contact you with the next steps. Rest assured, all submitted information will be kept confidential. If you have any questions before submitting, feel free to email us at PGxInfo@pgxally.com.

First name

Last name

Company name

Address

Phone

What is your estimated weekly patient load?

What is your total patient load?

What lab vendor are you you using?

What PGx platform are you using?

What payment models are you using? Membership or fee for service?

Do you accept insurance?

Upload a copy of your government issued ID

Upload a copy of your RPh license in each state you are licensed.

Upload a copy of your PGx CE or certification

Upload a copy of your liability insurance