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Join CIIC – Physicians
If you are a Board-Certified Allergist / Immunologist who is interested in joining the CIIC, please fill out the information below and someone will be in contact with you.
Full Name:
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Email:
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Phone:
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Company Name
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Do you currently Buy & Bill in your office?
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Yes
No
No, but I would like to
What products do you Buy & Bill?
IVIG
SCIG
Biologics
Allergy Extracts
Vaccines
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Do you currently participate in research?
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Yes
No
No, but I would like to
What EMR do you use?
How did you hear about the CIIC?
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