home : product : imedconsent PE
 

 



 

Request for Evaluation License
(this is required to install the software for evaluation)

Please complete the form below and you will receive an email message with a serial number and link to download the application.

Limitations of the Evaluation Version of the iMedConsent™ PE application: Evaluation version is operable for 30 days, there is no ability to print documents, there is no ability to customize documents. Please employ the evaluation period to review the content supplied and confirm that it meets the requirements of your practice.

Minimum System Requirements: Windows XP, no previously installed versions of the iMedConsent™ application.

first name
last name
practice/facility name
email
confirm email
policy number

(items in red indicate required fields)
Don't know your MedPro policy number?  Please contact your agent or a
Medical Protective representative at 1-800-4MEDPRO (1-800-463-3776).

Note: Order information will be reported to Medical Protective. Dialog Medical will not report order information to any other third parties without the permission of the MedPro insured.

 

Copyright © 2000 - 2008 by iMedConsent LLC. All rights reserved.
Terms and Conditions | Privacy Policy