Bausch & Lomb: Create your Web page/Registration


		Ready to help your patients and your practice? Just follow a few easy steps. Of course, you can always revise your page later. NOTE: At this time, we are only able to offer free Web pages to optometrists and ophthalmologists. Bausch & Lomb offers this as a free service to eye care professionals. We reserve the right to discontinue this service in its entirety or for any particular practitioner at any time and for any reason, without notice or liability.

Required fields are indicated by an *

* First Name

Middle Initial

* Last Name

Medical Education #

B&L Account #

* Specialty

* Your email address (for your Resource Center account)

Email address of your practice (for your patients)

Office

Practice Name

* Address 1

Address 2

* City

* State

* Zip

* Phone

Emergency Phone

Fax

*Office Hours

Additional Office

Practice Name

Address 1

Address 2

City

State

Zip

Phone

Fax

Office Hours

Link to a related Web site (example: URL for your practice, eye care site of interest to your patients)

http://www