Surescripts
Put trusted intelligence to
work for you
Provide your information and we will be in touch.
First Name*
Last Name*
Job Title*
Company Name*
Which best describes your business?*
Who is your EHR vendor?*
Who is your pharmacy software vendor?*
Do you have an established U.S. legal entity?*
Company Website URL*
Phone Number*
Products of Interest*
Care Event Notifications
Clinical Direct Messaging
E-Prescribing
Electronic Benefit Verification
Electronic Prior Authorization
Eligibility
Formulary
Medication History for Ambulatory
Medication History for Populations
Medication History for Reconciliation
Real-Time Prescription Benefit
Record Locator & Exchange
Therapeutic Alternatives
Touchless Prior Authorization
Who is your customer as it relates to potential interactions with Surescripts?*
Health Plan
Independent Pharmacy / Retail Pharmacy / DTC Pharmacy
Patient / Consumer
Patient Access Vendors
Pharma Manufacturer / Life Sciences
Physician / Physician Practice / Hospital / Health System
Technology Platform / Software Vendor
Tell us more about what you'd like to accomplish with Surescripts.* Please do not submit Protected Health Information via this form.
Connect with our sales team and see how Surescripts solutions can help you reduce costs, increase safety and ensure quality care.
Have a question about Surescripts that isn't sales related? Visit our contact us page.
Surescripts Helath Information Network
Want to learn how Surescripts Health Information Network LLC™ can help you if designated as a Qualified Health Information Network™? Visit our Interconnect product page.