New Account Registration

A user account is required to sign up for a free trial. Use the form below to create a new user account. All fields are required.

An email will be sent to you by the end of the business day with log in information so that you can begin using the application. Please email us at codonixinfo@codonix.com or call us at 800-495-7270 x701 for questions or assistance.

60 Day Free Trial
First Name	Please enter first name
Last Name	Please enter last name.
E-Mail Address	Please enter email.Please enter email.
Choose a User Name Must be at least six letters or numbers	Please enter at leat 6 letters or numbers.Minimum number of characters not met.
Choose a Site Name Enter a descriptive name for your office or facility e.g. Bay Medical Clinic. This is the name displayed on your site.	Please enter a site name.
Choose a Site Login Name Enter a short name for your office or facility up to 32 letters with no spaces e.g. BayClinic or Bay for Bay Medical Clinic. This is the name you will use to log into your site.	Please enter a site login name.
Product Select the products you want to use	ED/Urgent Care Office Please select at least 1 product.
Phone Number	Please enter a phone number.
Street	Please enter a street.
City	Please enter a city.
State	Please select a state.
ZIP	Please enter a zip code.
Country	Please select an country.
By sending this information to CodoniX, you are agreeing to the terms of our licensing agreement. To download and view the licensing agreement please click on the following link. Licensing Agreement I accept I decline You cannot submit the form until you accept the terms of the licence agreement!