Talar Medical | GPO

Join Talar

Join Talar Medical

Fill out the following form.  Once submitted, click on the Intalere button located the bottom of this page to complete the Intalere registration. 

    Member Information

    Contact Name*
    DPM Name (if different from above)
    Business Name

    Email*
    Phone Number*
    Fax Number

    Preferred Contact Method

    Address

    Business Address


    Street Address
    City
    State
    Zip Code

    Shipping & billing address the same?

    Shipping Address


    Street Address
    City
    State
    Zip Code

      Optional

    1. Number of providers in your practice:

    2. Is this a generalized number?

    3. How did you hear about Talar Medical?

    4. Who referred you?


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