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Register as a Provider or Practice

Practice Name (If Applicable) *

Providers First Name *

Providers Last Name *

Street Address *

Street Address Line 2

City *

Region/State/Province *

Postal/Zip code *

Email address where reports should be sent *

Phone Number *

Create Your Unique Provider Code *

Choose your preferred payment option *

I will recommend CatchU and the patient will order and purchase the testI/my practice will pay $29 for each CatchU testI plan to have a mix of patient pay and practice pay

* For all scenarios Medicare and commercial payer reimbursement for a telemedicine visit is eligible when results and recommendations are communicated to the patient. (For eligible providers)

CatchU is a product of JET Worldwide Enterprises Inc.

9 Margarita Drive
Stony Point, NY 10980

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