Participant Enrollment - Step 1

Please follow these instructions to complete your enrollment process:
  • If you click CANCEL your enrollment information will not be saved.

  • If you have trouble registering or have questions about the registration/confirmation process, please contact via email at or by calling Reward Headquarters at 1-866-431-9069.

    You must have Adobe Acrobat Reader intalled on your computer to finish the enrollment process. Click here to download a free version of Adobe Acrobat Reader.
    * Company Name  
    * Program ID #  
    * First Name  
    * Last Name  
    * User Class:
    * Country:
    * Address 1    
    Address 2
    * City    
    * State/Province
    * Postal Code    
    * County  
    * Phone  
    Mobile Phone
    * Email  
    * Confirm Email    
    * Username  
    * Password Case Sensitive  
    * Confirm Password    

    Please enter your account information for the following companies. If you do not have this information it is OK to leave it blank or enter it at a later time. However, if you do not provide this information we will not be able to process rewards for those sales.

    My Medco Account#

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