Best Point of Contact (required)
Phone Number (required)
Please enter your EIN. Format: XX-XXXXXXX.
If the BAA should be signed by someone else in your clinic, please specify who the BAA should be sent to for review and signature
Contact Email Address
Contact us at 800-978-3305 or firstname.lastname@example.org for assistance in creating your AIM or Beacon LBS credentials.
If you don't have credentials yet, you can still complete your enrollment and we will assist you.
Access your account here
I acknowledge that to complete enrollment I must sign and submit a BAA and Authorization Form, which will be emailed to the address provided above.