PRACTICE REGISTRATION FORM

Enter your practice information to be set up in the Bausch + Lomb REACH Marketing Portal

Upload Practice Logo (Optional)

Minimum 1200 pixels wide. Format: PNG, JPG, or GIF (not PDF or DOC). Logos will appear on a white background.

Do you want to add another location to this account?

Yes No

Practice Ship To # *

8 digits - Add leading zero

Practice Zip Code *

PRACTICE REGISTRATION FORM

Thank You!

Your registration has been received and is being processed.

A Welcome email with your secure login credentials to the REACH Portal will be sent shortly.

Your registration has been received and will be reviewed within the next business day.

Upon approval, a Welcome email with your secure login credentials to the REACH Portal will be sent to your practice.

Upon receipt, log in to the portal at: BauschREACH.com
To ensure receipt of Bausch + Lomb Reach emails, please add "support@bauschreach.com" to your address book or your safe senders list. For assistance, please contact: support@bauschreach.com