If you do not want to pay for access to PrOrthoAssist.com using Pay Pal, you can purchase access by check.  Complete the information below, and the mailing address where you can send your check will be e-mailed to you.  Once your check has been received, a password will be sent to your e-mail address. 

 If you wish to pay by credit card over the telephone, please enter your day time phone number.  You will be contacted for your credit card information, and a password will be sent to your email. 

Please allow 3-4 days to process your request.  Thank you!

Purchase Information

First Name 

Last Name 

Street Address    

City              State          Zipcode                

Telephone Number (optional)     must be include if paying with a credit card

Enter a Login Name: 

Enter e-mail address:  -- required *******