USADD New Member Signup

Registering for your FREE website is quick and easy!

Step 1: Fill out and submit this form. Make sure you enter the information completely and accurately. This is the information that will be displayed on your website. You may edit this information later by logging into the Members Only section of USADD.

Step 2: A USADD representative will contact your office to confirm your information. You will be contacted directly if you do not enter a contact person on the form.

Step 3: Once your information is confirmed, you will receive your temporary password via the e-mail address you entered during signup. Your website will become active with a random theme.

Step 4: Login to the Members Only area of USADD to change your password, edit your practice or personal information, activate your website e-mail, change your website theme and more!
Personal Information
* Required Field
*First Name:
Middle Initial/Name:
*Last Name:
Suffix:
  
*Gender:
*E-Mail Address:
*Dental School:
*Year Graduated:
*Degree:
*Specialty:
 
Practice Information
DBA/Trade Name:
*Office Address:
Suite:
*City:
*State:
*Zip:
*Office Phone:
Fax #:
*Active Patient Count:
 (Required for data storage allocation.)
Contact Person:
   
Additional Languages Spoken:
 
 
   
*Desired Username:
 (6-8 characters)
   
*Who can we thank for your referral?:
 
Website Address
Please enter your choices for your website address in
order of preference below. You will be given the first available
address from the choices you entered.

Example: drsmith.usadd.com
Example: familydental.usadd.com
Choice #1:
 .usadd.com
Choice #2:
 .usadd.com
Choice #3:
 .usadd.com
 
If you already have a practice website and would like to have it linked to your USADD website, please enter the URL below:
 
http://
 
Office Hours
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
   
Practice Associates
Please provide the name of your associates:

Associate #1:
Associate #2:
Associate #3:
   
By clicking Submit below you agree to the Terms of Use