Get started with BTI.

Complete the form below and we will send you everything you need to send your first case, including a price list, scheduling guide, and shipping information.

Business Name

Business Type

Billing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Shipping Address

(if different than billing address)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Doctor Information

Primary Doctor

First Name

Last Name

Additional Doctor(s)

Primary Contact Information

Name

First Name

Last Name

Email

Phone

(###)

###

####

Supplies

Requested Supplies

(Rx forms are not required when entering cases online)

Rx forms

Boxes

Bags

Shipping label

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