Remember to include your name and contact information, and the name of your practice/agency. For security purposes we will only send the Login ID and Password to the fax number or email address we have already registered to your account.

Your Name
Practice/Agency Name
Email
Phone	() -
Region	Select New York Florida
Reason for Contact	Select Forgot User Name & Password Update My Account Apex Mobile Apex Web Scheduler Request Forms Supplies Other
Comments	(If you are part of a group practice, please list the providers and their NPI's so we can link them your group practice account)
Please verify	Get a new verfication code Write the characters in the image above
	*Please note: Login details will not be provided via email to non-corporate email addresses. A temporary password will be faxed to the fax number Apex has listed to your account.