Welcome to General Informatics

Customer Registration

We can't wait to get started.

We’re excited that you’re with us, and we look forward to providing you with our signature top-notch service.

Please fill out the form below so we can collect some basic information about your company along with contact and billing information.

Client Implementation Form

This form will take approximately 15 minutes to complete.

Step 1 of 8

Submitter Information

Email(Required)

Legal Company Information

Legal Company Name(Required)

Tax ID Number(Required)

Purchase Order Required?(Required)

Type of Company(Required)

Special Tax Information

Tax-Exempt?(Required)

Select Tax-Exempt Entity Type or Not Applicable(Required)

If you are tax-exempt, please upload a copy of the corresponding tax exempt form or direct pay permit(Required)

Max. file size: 256 MB.

General Company Information

Company Address(Required)

Primary Phone Number(Required)

Fax Number

# of Years in Business(Required)

# of Employees(Required)

Bill-To Contact Information

All invoices will be delivered electronically to the Primary Bill-To email address listed in this section. If additional recipients are needed, please indicate in the space provided.

Payment Terms: DUE UPON RECEIPT

Remit-To Address:
PO Box 83335
Baton Rouge, LA 70884-3335

Bill-To Address(Required)

Primary Bill-To Email Address(Required)

Additional Bill-To Email Address

Accounts Payable Contact Information

A/P Contact Name(Required)

A/P Contact Title(Required)

A/P Contact Email Address(Required)

A/P Contact Phone Number(Required)

Finance Department Contact Information

Finance Contact Name(Required)

Finance Contact Title(Required)

Finance Contact Email Address(Required)

Finance Contact Phone Number(Required)

Additional Comments

Please enter any comments here.

Headquarters

Baton Rouge, LA

New Orleans, LA

Charlotte, NC

Birmingham, AL

Auburn, AL

Dallas, TX

Beaumont, TX

Welcome to General Informatics

Customer Registration

We can't wait to get started.

Client Implementation Form

Submitter Information

Legal Company Information

Special Tax Information

General Company Information

Bill-To Contact Information

Payment Terms: DUE UPON RECEIPT

Accounts Payable Contact Information

Finance Department Contact Information

Additional Comments

Headquarters

Welcome to General Informatics

Customer Registration

We can't wait to get started.

Client Implementation Form

Submitter Information

Legal Company Information

Special Tax Information

General Company Information

Bill-To Contact Information

Payment Terms: DUE UPON RECEIPT

Accounts Payable Contact Information

Finance Department Contact Information

Additional Comments

Don Monistere