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DoseSpot Registration

DoseSpot Registration Form

Requirements

  • Open Dental Version 21.2 or greater. The latest stable version is recommended. See Sign up for DoseSpot
  • A high-speed internet connection.
  • Microsoft Edge.
  • A valid Open Dental registration key. The key must be active (currently on support) to enable the Dosespot integration.
  • The Open Dental eConnector must be installed.
  • Computers used for e-Prescribing must be using Windows Version 10 or greater, or Server 2016 or greater.


Provider Info
First Name


Last Name


Phone #


Practice Administrator Email


DEA #


Personal NPI #


Birthdate


Office Name


Register for EPCS?




Name of person submitting form
Clinic Info
Clinic/Practice Name


Address


City


State


Zip Code


Phone #


Fax #


Practice Administrator* (First and Last)

Practice Administrator Email


ADSO Member or 75+ Providers?


list all non-providers (proxy clinicians) who will access DoseSpot and their email addresses (required if using stand-alone)

*Designate a staff member (typically an office manager) who will be the point of contact and own the DoseSpot sign up process for providers and proxy clinicians. This person will need admin permissions in Open Dental and must be a non-provider. To register additional proxy (non-provider) users please send an email with their first and last names to erx@opendental.com.




*When you submit this form, an email for your records will be sent to the Practice Administrator's address entered above with instructions on your next step. After receiving the email, your next step is to forward that email to eRx@opendental.com when you are ready for Open Dental to generate the ClinicID and/or Provider ID. Please note that once the IDs are generated charges will be initiated and because they involve multiple third parties, they cannot be refunded by Open Dental regardless of whether or not the provider completes the registration process. Please notify Open Dental immediately if you do not wish to proceed at any point in the process, in order to minimize the charges.

Open Dental Software 1-503-363-5432