< Sign Up « AnswerFirst

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Fill out the form below.
Questions? Call: 800-645-2616

Please complete all fields. Click in the text boxes to begin typing. Once we have received this information we will begin building your new account.

Step 1 of 3

Contact Information
* First Name:
* Last Name:
* Phone:
* E-mail:
* Business Name:
* Business Phone:
Business Fax:
* FEIN or SS #:
* Business Address (must be a physical address. No P.O. Boxes.):

Suite or Apt #:
* City/Town/Locality:

* State/Province:

* Zip/Postal:

Country (if not USA):

Under HIPAA is the business contracting for services with AnswerFirst considered to be a Covered Entity? (This includes health care providers, health care clearinghouses and/or a health plans.)
(If unsure, please click this link.)
No Yes
By completing this account signup form and selecting "Agree", I attest that I have read, understand and agree to immediately enter into and be bound by BOTH the Business Associate Contract and the Terms Of Service. I further attest that I am legally authorized to enter into BOTH of these agreements and am authorizing AnswerFirst to begin billable services and my account setup.

By completing this account signup form and selecting "Agree", I attest that I have read, understand and agree to immediately enter into and be bound by the Terms Of Service. I further attest that I am legally authorized to enter into this agreement and am authorizing AnswerFirst to begin billable services and my account setup.

Agree Decline
Enter your first & last name to show agreement:
 

Step 2 of 3

Billing Information

* How would you like to receive invoices?

(Free) - Please E-Mail My Invoice To:
Please add billing@answerfirst.com and dispatch@answerfirst.com to your personal and\or corporate email "white lists" to insure email is not marked as spam.

Regular Mail - Only for domestic U.S. addresses. $ 4 per invoice paper fee applies.

Please provide your U.S. billing address:

  Use my U.S. business address.
* Billing Address:  Suite or Apt #:
* City:   * State:   * Zip Code:
 

Step 3 of 3

Payment Information
* How would you like to pay for service?
  
Credit Card eCheck Apply for Credit Terms

Do you already have an AnswerFirst Account? Yes    No
If yes, please provide the account name or #:
Provide a brief description of what your company does:
Comments:
Once you submit this form you will be directed to setup your script. If you choose not to complete the setup form at this time, we will get you started with a basic messaging account. Don't worry, you will have an opportunity to customize your account at a later date.