{"id":568,"date":"2024-05-28T19:07:09","date_gmt":"2024-05-28T19:07:09","guid":{"rendered":"https:\/\/nimble-riddle.flywheelsites.com\/?page_id=568"},"modified":"2025-11-27T04:59:45","modified_gmt":"2025-11-27T09:59:45","slug":"provider-registration","status":"publish","type":"page","link":"https:\/\/progresspharmacy.com\/provider-registration\/","title":{"rendered":"Provider Registration"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"568\" class=\"elementor elementor-568\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0ffb81a e-con-full e-flex e-con e-parent\" data-id=\"0ffb81a\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-9c254e7 auth-form-wrapper e-flex e-con-boxed e-con e-child\" data-id=\"9c254e7\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0c733e7 elementor-widget elementor-widget-image\" data-id=\"0c733e7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/progresspharmacy.com\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"172\" height=\"49\" src=\"https:\/\/progresspharmacy.com\/wp-content\/uploads\/2024\/08\/logo.png\" class=\"attachment-full size-full wp-image-803\" alt=\"Progress Pharmacy\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bd40363 elementor-widget elementor-widget-text-editor\" data-id=\"bd40363\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Progress Pharmacy is your pipeline into a <em><strong>NETWORK<\/strong><\/em> of the <em><strong>most trusted<\/strong><\/em> pharmacies for some of the <em><strong>most competitive<\/strong><\/em> pricing on the <em><strong>most sought after<\/strong><\/em> solutions for:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8c6db14 e-con-full e-flex e-con e-child\" data-id=\"8c6db14\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-96e9142 elementor-widget elementor-widget-text-editor\" data-id=\"96e9142\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>Weight Loss &amp; Body Composition<\/li><li>Gut Health &amp; Immune Dysregulation<\/li><li>Tissue Repair &amp; Regeneration<\/li><li>Cognitive Function &amp; Stress Management<\/li><li>Longevity &amp; Performance<\/li><li>And More!<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3055e84 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"3055e84\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e374383 eael-gravity-form-button-custom elementor-widget elementor-widget-eael-gravity-form\" data-id=\"e374383\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"eael-gravity-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t<div class=\"eael-contact-form eael-gravity-form eael-contact-form-align-default\">\n\t\t        <script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_unknown gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_7' style='display:none'>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_7'  action='\/wp-json\/wp\/v2\/pages\/568' data-formid='7' novalidate> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n                        <div class='gform-body gform_body'><div id='gform_fields_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_7_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_7_22'>Source<\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_7_22' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_7_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Provider Information<\/h3><\/div><fieldset id=\"field_7_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Provider Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_7_1'>\n                            \n                            <span id='input_7_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_7_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_7_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_7_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_7_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_7_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_7_3\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gpev-field\"  data-field-class=\"gpev-field\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Provider Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_7_3_container'>\n                                <span id='input_7_3_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_3' id='input_7_3' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_7_3' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_7_3_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_3_2' id='input_7_3_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_7_3_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_7_41\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_41'>Where did you hear about us?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_41' id='input_7_41' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='nuBioAge' >nuBioAge<\/option><option value='Google ads' >Google ads<\/option><option value='Facebook ads' >Facebook ads<\/option><option value='Social Media' >Social Media<\/option><option value='Event' >Event<\/option><option value='Google search' >Google search<\/option><option value='Chat GPT search' >Chat GPT search<\/option><option value='Colleague\/Network' >Colleague\/Network<\/option><\/select><\/div><\/div><div id=\"field_7_39\" class=\"gfield gfield--type-username gfield--input-type-username gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_39'>Username<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_7_39' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_7_40\" class=\"gfield gfield--type-password gfield--input-type-password gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Password<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_password gform-grid-row' id='input_7_40_container'>\n\t\t\t\t\t\t<span id='input_7_40_1_container' class='ginput_password ginput_left gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_40' id='input_7_40' onkeyup='gformShowPasswordStrength(\"input_7_40\");' onchange='gformShowPasswordStrength(\"input_7_40\");' aria-describedby=\"input_7_40_strength_indicator gfield_description_7_40\" value=''   aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t\t\t\t<button type='button' class='gform_show_password gform-theme-button gform-theme-button--simple' onclick='javascript:gformToggleShowPassword(\"input_7_40\");' aria-live='polite' aria-label='Show Password' data-label-show='Show Password' data-label-hide='Hide Password'><span class='dashicons dashicons-hidden' aria-hidden='true'><\/span><\/button>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<label for='input_7_40' class='gform-field-label gform-field-label--type-sub '>Enter Password<\/label>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span id='input_7_40_2_container' class='ginput_password ginput_right gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_40_2' id='input_7_40_2' onkeyup='gformShowPasswordStrength(\"input_7_40\");' onchange='gformShowPasswordStrength(\"input_7_40\");' value=''   aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t\t\t\t<button type='button' class='gform_show_password gform-theme-button gform-theme-button--simple' onclick='javascript:gformToggleShowPassword(\"input_7_40_2\");' aria-live='polite' aria-label='Show Password' data-label-show='Show Password' data-label-hide='Hide Password'><span class='dashicons dashicons-hidden' aria-hidden='true'><\/span><\/button>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<label for='input_7_40_2' class='gform-field-label gform-field-label--type-sub '>Confirm Password<\/label>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<div class='gf_clear gf_clear_complex'><\/div>\n\t\t\t\t\t<\/div><div id='input_7_40_strength_indicator' class='gfield_password_strength'  aria-live='assertive' aria-atomic='true'>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tStrength indicator\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input type='hidden' class='gform_hidden' id='input_7_40_strength' name='input_40_strength' \/><div class='gfield_description' id='gfield_description_7_40'>Your password should contain a combination of letters, numbers, and symbols.<\/div><\/fieldset><div id=\"field_7_4\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_4'>Provider Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_4' id='input_7_4' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_7_8\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Email and SMS Consent<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_7_8'><div class='gchoice gchoice_7_8_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.1' type='checkbox'  value='I consent to receive marketing emails and SMS messages for sales, new product info, and other announcements from Progress Pharmacy' checked='checked' id='choice_7_8_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_8_1' id='label_7_8_1' class='gform-field-label gform-field-label--type-inline'>I consent to receive marketing emails and SMS messages for sales, new product info, and other announcements from Progress Pharmacy<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_9\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_9'>Are you legally authorized to prescribe medications?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_7_9' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='No' >No<\/option><option value='Yes' >Yes<\/option><\/select><\/div><\/div><div id=\"field_7_29\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_29'>Please select your License<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_29' id='input_7_29' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Medical Doctor - MD' >Medical Doctor - MD<\/option><option value='Doctor of Naturopathy - ND' >Doctor of Naturopathy - ND<\/option><option value='Doctor of Osteopathy - DO' >Doctor of Osteopathy - DO<\/option><option value='Nurse Practitioner - NP' >Nurse Practitioner - NP<\/option><option value='Physician Assistant - PA' >Physician Assistant - PA<\/option><option value='Dentist' >Dentist - DDS\/DMD<\/option><option value='Pharmacist - PharmD' >Pharmacist - PharmD<\/option><option value='Doctor of Chiropractic - DC' >Doctor of Chiropractic - DC<\/option><option value='Nurse Anesthetist - CRNA' >Nurse Anesthetist - CRNA<\/option><option value='Registered Dietician - RD, RDN' >Registered Dietician - RD, RDN<\/option><option value='Registered Nurse - RN' >Registered Nurse - RN<\/option><option value='Health Coach' >Health Coach<\/option><option value='PhD' >PhD<\/option><option value='Physical Trainer' >Physical Trainer<\/option><option value='Exercise Scientist' >Exercise Scientist<\/option><option value='I am a patient' >I am a patient<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_7_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_30'>License?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_7_30' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_7_31\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Important Notice<\/h3><div class='gsection_description' id='gfield_description_7_31'>Thank you for your interest in registering with Progress Pharmacy. Unfortunately, it appears you don't meet the current legal requirements for writing prescriptions that Progress Pharmacy can fill. If you have any questions or believe this may be an error, please reach out to our support team at 855-212-1997 for further assistance.<\/div><\/div><div id=\"field_7_32\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Important Notice<\/h3><div class='gsection_description' id='gfield_description_7_32'>Thank you for your interest in registering with Progress Pharmacy. The form is meant for prescribers to register with us to fill prescriptions for their patients. \n\nOur partner, nuBioAge, offers supplements for sale that do not require a prescription.  You can check them out at shop.nubioage.com.  If you have any questions or believe this may be an error, please reach out to our support team at 855-212-1997 for further assistance.<\/div><\/div><div id=\"field_7_33\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><a href=\"https:\/\/shop.nubioage.com\">shop.nubioage.com<\/a><\/div><div id=\"field_7_28\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Prescriber Details<\/h3><\/div><div id=\"field_7_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_5'>License #<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_7_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_7_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_6'>DEA<\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_7_6' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_7_7\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_7'>NPI<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_7_7' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_7_10\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_7_10'>License Documentation<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_7_10' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_7_10&quot;,&quot;container&quot;:&quot;gform_multifile_upload_7_10&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_7_10&quot;,&quot;filelist&quot;:&quot;gform_preview_7_10&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/progresspharmacy.com\\\/?gf_page=5b5907dd1fc5fa2&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/progresspharmacy.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/progresspharmacy.com\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,pdf,jpeg,png,heic&quot;}],&quot;max_file_size&quot;:&quot;2146435072b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:7,&quot;field_id&quot;:10,&quot;_gform_file_upload_nonce_7_10&quot;:&quot;3aaee0d35a&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_7_10&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_7_10' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_7_10' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_7_10\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_7_10'>Accepted file types: jpg, pdf, jpeg, png, heic, Max. file size: 2 GB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_7_10'><\/ul> <div id='gform_preview_7_10' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_7_12\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Clinic Information<\/h3><\/div><div id=\"field_7_15\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_7_15'>Clinic Name<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_7_15' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_7_14\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"   data-js=\"geolocation-enabled\"><legend class='gfield_label gform-field-label gfield_label_before_complex' >Clinic Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_7_14' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_7_14_1_container' >\n                                        <input type='text' name='input_14.1' id='input_7_14_1' value=''    aria-required='true'    \/>\n                                        <label for='input_7_14_1' id='input_7_14_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_7_14_2_container' >\n                                        <input type='text' name='input_14.2' id='input_7_14_2' value=''     aria-required='false'   \/>\n                                        <label for='input_7_14_2' id='input_7_14_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_7_14_3_container' >\n                                    <input type='text' name='input_14.3' id='input_7_14_3' value=''    aria-required='true'    \/>\n                                    <label for='input_7_14_3' id='input_7_14_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_7_14_4_container' >\n                                        <select name='input_14.4' id='input_7_14_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_7_14_4' id='input_7_14_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_7_14_5_container' >\n                                    <input type='text' name='input_14.5' id='input_7_14_5' value=''    aria-required='true'    \/>\n                                    <label for='input_7_14_5' id='input_7_14_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_14.6' id='input_7_14_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <input type='hidden' class='gform_hidden' name='input_14.geolocation_latitude' id='input_7_14_geolocation_latitude' value=''\/><input type='hidden' class='gform_hidden' name='input_14.geolocation_longitude' id='input_7_14_geolocation_longitude' value=''\/><\/div><\/fieldset><div id=\"field_7_36\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Practitioner Consents<\/h3><\/div><fieldset id=\"field_7_18\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Patient Counseling Notice<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_18.1' id='input_7_18_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_7_18\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_7_18_1' >\u00a0I consent to the below policy<\/label><input type='hidden' name='input_18.2' value='\u00a0I consent to the below policy' class='gform_hidden' \/><input type='hidden' name='input_18.3' value='4' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_7_18' tabindex='0'>Prescriber agrees that all prescriptions sent to Progress Phamacy have met the criteria listed, or are in full compliance with state and federal laws regarding a valid patient\/doctor relationship.<br \/>\n<br \/>\nProgress Pharmacy is committed to compliance with state and federal laws. We are aware that some patients reside in states differing from their prescriber. To ensure that all prescriptions received by Progress Pharmacy are pursuant to a valid patient\/doctor relationship, we require that the prescriber agrees that the following elements are met prior to sending us a prescription.<br \/>\n<br \/>\nPrior to ordering, prescriber agrees to the following:<br \/>\n<br \/>\n1. In person and\/or using live video conferencing equipment, prescriber will perform a documented patient evaluation, including history and physical examination, adequate to establish a diagnosis of patient\u2019s condition for which any drug is prescribed. If the patient cannot travel to your office then you agree to supervise an exam given by a nurse or other professional and base your decision to prescribe the needed medications based on the results and the facts (symptoms, blood pressure, etc.) that have been verified by a qualified third party and observed by you electronically.<br \/>\n2. In person and\/or using live video conferencing equipment, prescriber will maintain sufficient dialogue with patient regarding treatment options and the risks and benefits of treatment for patient\u2019s condition.<br \/>\n3. Prescriber agrees to create a follow-up care plan for patient.<br \/>\n4. Prescriber acknowledges and agrees not to prescribe a prescription to a patient based solely on an Internet\/online questionnaire, consultation, phone call or email.<br \/>\n5. Prescriber will maintain contemporaneous medical records.<br \/>\n6. Prescriber will obtain either verbal or written informed consent from patient prior to delivery of service.<br \/>\n7. Prescriber acknowledges that prescriptions are not intended for 'office use'.<\/div><\/fieldset><fieldset id=\"field_7_20\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Controlled Substance Security Requirements and Record Keeping<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_20.1' id='input_7_20_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_7_20\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_7_20_1' >\u00a0I consent to the below policy<\/label><input type='hidden' name='input_20.2' value='\u00a0I consent to the below policy' class='gform_hidden' \/><input type='hidden' name='input_20.3' value='4' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_7_20' tabindex='0'>Progress Pharmacy is committed to compliance with state and federal laws. To ensure that all controlled substances dispensed and\/or shipped by Progress Pharmacy will be handled in accordance with these state and federal laws, we require that the prescribing physician acknowledges the following:<br \/>\n<br \/>\n1. Prescriber acknowledges his\/her responsibilities for compliance under Title 21, CFR Section 1301.7(a) requiring all registrants of controlled substances provide effective controls and procedures to guard against theft and diversion of controlled substances.2. Prescriber acknowledges federal law and many states have controlled substance inventory, records, and prescription monitoring reporting requirements and such prescribing physician acknowledges to fulfill this duty in the lawful course of his\/her professional practice.<\/div><\/fieldset><fieldset id=\"field_7_24\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Patient Pharmacy Choice Acknowledgement<\/legend><div class='ginput_container ginput_container_consent'><input name='input_24.1' id='input_7_24_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_7_24\"  aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_7_24_1' >I acknowledge the below requirement.<\/label><input type='hidden' name='input_24.2' value='I acknowledge the below requirement.' class='gform_hidden' \/><input type='hidden' name='input_24.3' value='4' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_7_24' tabindex='0'>As a prescriber, you are required to:<br \/>\n1. Inform your patients of their right to choose any pharmacy for their medications.<br \/>\n2. Provide patients with clear and unbiased information regarding their pharmacy options.<br \/>\n3. Ensure that your recommendations or preferences do not influence or limit the patient\u2019s choice of pharmacy.<br \/>\n4. Facilitate the transfer of prescriptions to the pharmacy chosen by the patient promptly and without bias.<\/div><\/fieldset><fieldset id=\"field_7_26\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_26.1' id='input_7_26_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_7_26_1' >I consent to receive marketing emails for sales, new product info, and other announcements from Progress Pharmacy.<span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/label><input type='hidden' name='input_26.2' value='I consent to receive marketing emails for sales, new product info, and other announcements from Progress Pharmacy.' class='gform_hidden' \/><input type='hidden' name='input_26.3' value='4' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_7_25\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_7_25'>Type<\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_7_25' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_7' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_7' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_7' id='gform_theme_7' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_7' id='gform_style_settings_7' value='' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_7' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='7' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='MVkZ\/lPB0sIaBMGI7\/a\/F3OTTka4I2rBxGciG540oUWjUORVEbGYzSFVWda49soYSL2DFPL6ntqt8WqKCge88yCAlSqgqBrft7pU6p05ShMUW+I=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_7' value='WyJ7XCI0MVwiOltcImIxMjc5MTE2MzQ4MDUxZjJmN2NkMThjODA5ODE5MmZhXCIsXCJkYTM4MzgwMmM5OGQ5YTI2ZmQwZjlkNjQyMTI3NTI0N1wiLFwiMmI5ZjFkN2U0YzM3YTEyNDBlZDM5NTM5Y2IzYWZiNWVcIixcIjY1ZWUzZjcyNTgyYzRmODUzYjA4ZmI5MjMwOTJiNDYzXCIsXCJiNDk0MTg5OTQ0ODY1M2IxMmY5MTk5MWNmZjA0ZWRlYlwiLFwiNmJlMDkzMDJmNjQ3ZThlM2U5YWQ3NzAzMjUzOWU3M2ZcIixcIjM5MjlmZGU5ZDBjYTYwNWU1YWQ1YzA5ZWFhZWRiMzQ0XCIsXCI5MWY2NmQxNjRiNTNkZjgxOWJhY2M3MzY4ZWFiZTczYVwiLFwiYTdkZWEwNDMwNmYwMmQ5ZjMwNGY4ZWUzMGYyZDlhMjFcIl0sXCI4LjFcIjpcImY4OTQ2M2Q5ZjU1OWVmZGRiMGRmMTk0ZmZjZmU1MjUwXCIsXCI5XCI6W1wiYjEyNzkxMTYzNDgwNTFmMmY3Y2QxOGM4MDk4MTkyZmFcIixcImI3OWM1NTljMWRmODQ3YzU1YTgyMWIxMmFjMGIwYmY4XCIsXCI5OTAwOGIyMjhkYmEyNzA2NDVmYWU5NmJjNDk0YjY3ZFwiXSxcIjI5XCI6W1wiYjEyNzkxMTYzNDgwNTFmMmY3Y2QxOGM4MDk4MTkyZmFcIixcImY5NGIxNDE1YTA2NmI2NDY3YjAyM2Y1ODc0ZmE1ZDY0XCIsXCJiMTI3OWUyNjZlMzAzMGMxODVmMmUwNjIyNzIxOThmMVwiLFwiMTVlMjFhZjRiYTk1NGI3Njg4NWE2ZmE3MzE2MTA2YjdcIixcImRlNzk1YWE4NGI3YmM3OWU2ZGJkNTFlNTNjYzI0ZDMzXCIsXCJmMGM0Mzg3YmYzNjczYzQyN2M5Y2FkOTU0NWU1M2FlOVwiLFwiZWUyM2Q2YTY5YWJkNzAzMGEzMWNlMWU1OGY3MWVhNTFcIixcImM0ZTljYmQ2NGIzMjU2MTliN2I3ZTUxNTVhNDZjNjE2XCIsXCI0ZTY1MDI1MDUyZWJmYmI5OWUxNjMyZDRjZWQxZjVkM1wiLFwiM2IwMmQxZTViMTExZThmNGUxM2I5NTBmNzVkMTk4ZGFcIixcIjU2ZDczNTc5OTdhZGJjOTNmODZkYmY0N2UwOGMxYzNiXCIsXCI0NmZkMTI2NDA2ODA2YTMzNWE2OWY4NjU1Y2M5YmQ3ZFwiLFwiYjJiNDA5MTVkYWJlMGRhYmJkNmEyMDM1OTIwY2VmYTNcIixcIjgwMDM0MTM5NmY2OTc5MTE0ZDMzYjhkNDQ5NThhNDAyXCIsXCI5MmQzOGQ4MzEwYmY1MDU3YzY1ZWMyNzAwZTIwODZmZVwiLFwiY2UyOWNiMzgzMTMyYTViMWYwYWVhNzFjNDgwYWM1MGRcIixcIjAyMjk3MDQxZjkwZTA5YTk4Y2E2M2Y2ZGE1NWRjMWU3XCIsXCI2YzRlOTNlZTJlYzFmYjUzN2M3MmM3NzA2ZTUxMGM1ZlwiXSxcIjE4LjFcIjpcImZmODY5ODA1ZmU1MjY5Zjc4MDQ1YTIxYTVkYzAxZmYwXCIsXCIxOC4yXCI6XCIyN2ZlNjc1OTBjMjJhZjNhZjVjMTViMzZlZWQ2NDdhZFwiLFwiMTguM1wiOlwiMWQ0NDlkMjM2MjI1NzZlZDQ0Mzk1NWExZDM2YzRjY2JcIixcIjIwLjFcIjpcImZmODY5ODA1ZmU1MjY5Zjc4MDQ1YTIxYTVkYzAxZmYwXCIsXCIyMC4yXCI6XCIyN2ZlNjc1OTBjMjJhZjNhZjVjMTViMzZlZWQ2NDdhZFwiLFwiMjAuM1wiOlwiMWQ0NDlkMjM2MjI1NzZlZDQ0Mzk1NWExZDM2YzRjY2JcIixcIjI0LjFcIjpcImZmODY5ODA1ZmU1MjY5Zjc4MDQ1YTIxYTVkYzAxZmYwXCIsXCIyNC4yXCI6XCI5ZGE5NWI1ZTY5NzAxNGU5YzkwODRkMjEwYmM5NGM4YVwiLFwiMjQuM1wiOlwiMWQ0NDlkMjM2MjI1NzZlZDQ0Mzk1NWExZDM2YzRjY2JcIixcIjI2LjFcIjpcImZmODY5ODA1ZmU1MjY5Zjc4MDQ1YTIxYTVkYzAxZmYwXCIsXCIyNi4yXCI6XCJjZWVkYzc5NjFjMDYxNzI0MzA5ZjlkYmVlNTgxYjI3NFwiLFwiMjYuM1wiOlwiMWQ0NDlkMjM2MjI1NzZlZDQ0Mzk1NWExZDM2YzRjY2JcIn0iLCI5MjUyY2M2ZjQzNzA4ZGUwNTkwNGQ1ZTU5NDliMjM3MyJd' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_7' id='gform_target_page_number_7' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_7' id='gform_source_page_number_7' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            <input type='hidden' name='gform_uploaded_files' id='gform_uploaded_files_7' value='' \/>\n        <\/div>\n                        <\/form>\n                        <\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 7, 'https:\/\/progresspharmacy.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_7').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_7');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_7').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_7').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_7').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_7').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_7').val();gformInitSpinner( 7, 'https:\/\/progresspharmacy.com\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [7, current_page]);window['gf_submitting_7'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_7').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [7]);window['gf_submitting_7'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_7').text());}else{jQuery('#gform_7').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"7\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_7\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_7\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_7\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 7, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} ); \n\/* ]]> *\/\n<\/script>\n\t\t\t<\/div>\n\n            <script type=\"text\/javascript\">\n                var gf_global = {\"gf_currency_config\":{\"name\":\"U.S. Dollar\",\"symbol_left\":\"$\",\"symbol_right\":\"\",\"symbol_padding\":\"\",\"thousand_separator\":\",\",\"decimal_separator\":\".\",\"decimals\":2,\"code\":\"USD\"},\"base_url\":\"https:\\\/\\\/progresspharmacy.com\\\/wp-content\\\/plugins\\\/gravityforms\",\"number_formats\":[],\"spinnerUrl\":\"https:\\\/\\\/progresspharmacy.com\\\/wp-content\\\/plugins\\\/gravityforms\\\/images\\\/spinner.svg\",\"version_hash\":\"1aaef3c4291da9e34369e23582104df2\",\"strings\":{\"newRowAdded\":\"New row added.\",\"rowRemoved\":\"Row removed\",\"formSaved\":\"The form has been saved.  The content contains the link to return and complete the form.\"}};\t\t\t\tvar gf_vars = {\"active\":\"Active\",\"inactive\":\"Inactive\",\"save\":\"Save\",\"update\":\"Update\",\"previousLabel\":\"Previous\",\"selectFormat\":\"Select a format\",\"column\":\"Column\",\"editToViewAll\":\"5 of %d items shown. Edit field to view all\",\"selectAll\":\"Select All\",\"enterValue\":\"Enter a value\",\"formTitle\":\"Untitled Form\",\"formDescription\":\"We would love to hear from you! Please fill out this form and we will get in touch with you shortly.\",\"formConfirmationMessage\":\"Thanks for contacting us! We will get in touch with you shortly.\",\"buttonText\":\"Submit\",\"buttonDescription\":\"The submit button for this form\",\"loading\":\"Loading...\",\"thisFieldIf\":\"this field if\",\"thisSectionIf\":\"this section if\",\"thisPage\":\"this page if\",\"thisFormButton\":\"this form button if\",\"show\":\"Show\",\"hide\":\"Hide\",\"enable\":\"Enable\",\"disable\":\"Disable\",\"enabled\":\"Enabled\",\"disabled\":\"Disabled\",\"configure\":\"Configure\",\"conditional_logic_text\":\"Conditional Logic\",\"conditional_logic_desc\":\"Conditional logic allows you to change what the user sees depending on the fields they select.\",\"conditional_logic_a11y\":\"Adding conditional logic to the form submit button could cause usability problems for some users and negatively impact the accessibility of your form. Learn more about button conditional logic in our <a href=\\\"https:\\\/\\\/docs.gravityforms.com\\\/field-accessibility-warning\\\/\\\" target=\\\"_blank\\\" rel=\\\"noopener\\\">documentation<span class=\\\"screen-reader-text\\\">(opens in a new tab)<\\\/span>&nbsp;<span class=\\\"gform-icon gform-icon--external-link\\\" aria-hidden=\\\"true\\\"><\\\/span><\\\/a>.\",\"page\":\"Page\",\"next_button\":\"Next Button\",\"button\":\"Submit Button\",\"all\":\"All\",\"any\":\"Any\",\"ofTheFollowingMatch\":\"of the following match:\",\"is\":\"is\",\"isNot\":\"is not\",\"greaterThan\":\"greater than\",\"lessThan\":\"less than\",\"contains\":\"contains\",\"startsWith\":\"starts with\",\"endsWith\":\"ends with\",\"emptyChoice\":\"Empty (no choices selected)\",\"alertLegacyMode\":\"This form has legacy markup enabled and doesn\\u2019t support field resizing within the editor. Please disable legacy markup in the form settings to enable live resizing.\",\"thisConfirmation\":\"Use this confirmation if\",\"thisNotification\":\"Send this notification if\",\"confirmationSave\":\"Save\",\"confirmationSaving\":\"Saving...\",\"confirmationAreYouSure\":\"Are you sure you wish to cancel these changes?\",\"confirmationIssueSaving\":\"There was an issue saving this confirmation.\",\"confirmationConfirmDelete\":\"Are you sure you wish to delete this confirmation?\",\"confirmationIssueDeleting\":\"There was an issue deleting this confirmation.\",\"confirmationConfirmDiscard\":\"There are unsaved changes to the current confirmation. Would you like to discard these changes?\",\"confirmationDefaultName\":\"Untitled Confirmation\",\"confirmationDefaultMessage\":\"Thanks for contacting us! We will get in touch with you shortly.\",\"confirmationInvalidPageSelection\":\"Please select a page.\",\"confirmationInvalidRedirect\":\"Please enter a URL.\",\"confirmationInvalidName\":\"Please enter a confirmation name.\",\"confirmationDeleteField\":\"Deleting this field will also delete all entry data associated with it. 'Cancel' to abort. 'OK' to delete.\",\"confirmationDeleteDisplayField\":\"You're about to delete this field. 'Cancel' to stop. 'OK' to delete\",\"confirmationDeleteDisplayFieldTitle\":\"Warning\",\"conditionalLogicDependency\":\"This form contains {type} conditional logic dependent upon this field. Deleting this field will deactivate those conditional logic rules and also delete all entry data associated with the field. 'Cancel' to abort. 'OK' to delete.\",\"conditionalLogicDependencyChoice\":\"This form contains {type} conditional logic dependent upon this choice. Are you sure you want to delete this choice? 'Cancel' to abort. 'OK' to delete.\",\"conditionalLogicDependencyChoiceEdit\":\"This form contains {type} conditional logic dependent upon this choice. Are you sure you want to modify this choice? 'Cancel' to abort. 'OK' to continue.\",\"conditionalLogicDependencyAdminOnly\":\"This form contains {type} conditional logic dependent upon this field. Are you sure you want to mark this field as Administrative? 'Cancel' to abort. 'OK' to continue.\",\"conditionalLogicRichTextEditorWarning\":\"This form contains conditional logic dependent upon this field. This will no longer work if the Rich Text Editor is enabled.  Are you sure you want to enable the Rich Text Editor?  'Cancel' to abort. 'OK' to continue.\",\"conditionalLogicTypeButton\":\"button\",\"conditionalLogicTypeConfirmation\":\"confirmation\",\"conditionalLogicTypeNotification\":\"notification\",\"conditionalLogicTypeNoficationRouting\":\"notification routing\",\"conditionalLogicTypeField\":\"field\",\"conditionalLogicTypeFeed\":\"feed\",\"conditionalLogicWarningTitle\":\"Conditional Logic Warning\",\"mergeTagsText\":\"Insert Merge Tags\",\"baseUrl\":\"https:\\\/\\\/progresspharmacy.com\\\/wp-content\\\/plugins\\\/gravityforms\",\"gf_currency_config\":{\"name\":\"U.S. Dollar\",\"symbol_left\":\"$\",\"symbol_right\":\"\",\"symbol_padding\":\"\",\"thousand_separator\":\",\",\"decimal_separator\":\".\",\"decimals\":2,\"code\":\"USD\"},\"otherChoiceValue\":\"Other\",\"isFormTrash\":false,\"currentlyAddingField\":false,\"visibilityOptions\":[{\"label\":\"Visible\",\"value\":\"visible\",\"description\":\"Default option. The field is visible when viewing the form.\"},{\"label\":\"Hidden\",\"value\":\"hidden\",\"description\":\"The field is hidden when viewing the form. Useful when you require the functionality of this field but do not want the user to be able to see this field.\"},{\"label\":\"Administrative\",\"value\":\"administrative\",\"description\":\"The field is only visible when administering submitted entries. The field is not visible or functional when viewing the form.\"}],\"addFieldFilter\":\"Add a condition\",\"removeFieldFilter\":\"Remove a condition\",\"filterAndAny\":\"{0} of the following match:\",\"customChoices\":\"Custom Choices\",\"predefinedChoices\":\"Predefined Choices\",\"fieldLabelAriaLabel\":\"{field_label} - {field_type}, jump to this field&#039;s settings\",\"fieldCanBeAddedTitle\":\"Field Limit\",\"fieldCanBeAddedCaptcha\":\"A form can only contain one CAPTCHA field.\",\"fieldCanBeAddedShipping\":\"A form can only contain one Shipping field.\",\"fieldCanBeAddedPostContent\":\"A form can only contain one Post Body field.\",\"fieldCanBeAddedPostTitle\":\"A form can only contain one Post Title field.\",\"fieldCanBeAddedPostExcerpt\":\"A form can only contain one Post Excerpt field.\",\"fieldCanBeAddedCreditCard\":\"A form can only contain one Credit Card field.\",\"fieldCanBeAddedProductTitle\":\"Missing Product field\",\"fieldCanBeAddedProduct\":\"You must add a Product field to the form first.\",\"legacyMarkupTitle\":\"Unsupported Markup\",\"fieldCanBeAddedMultipleChoice\":\"You cannot add a Multiple Choice field to a form that uses legacy markup. Please edit the form settings and turn off Legacy Markup.\",\"fieldCanBeAddedImageChoice\":\"You cannot add an Image Choice field to a form that uses legacy markup. Please edit the form settings and turn off Legacy Markup.\",\"FieldAjaxonErrorTitle\":\"Error\",\"StartAddFieldAjaxonError\":\"Ajax error while adding field. Please refresh the page and try again.\",\"StartChangeInputTypeAjaxonError\":\"Ajax error while changing input type. Please refresh the page and try again.\",\"MissingNameCustomChoicesTitle\":\"Missing Name\",\"MissingNameCustomChoices\":\"Please give this custom choice a name.\",\"DuplicateNameCustomChoicesTitle\":\"Duplicate Name\",\"DuplicateNameCustomChoices\":\"This custom choice name is already in use. Please enter another name.\",\"DuplicateTitleMessageTitle\":\"Duplicate Title\",\"DuplicateTitleMessage\":\"The form title you have entered is already taken. Please enter a unique form title.\",\"ValidateFormMissingFormTitleTitle\":\"Missing Form Title\",\"ValidateFormMissingFormTitle\":\"Please enter a Title for this form. When adding the form to a page or post, you will have the option to hide the title.\",\"ValidateFormEmptyPageTitle\":\"Empty Page\",\"ValidateFormEmptyPage\":\"This form currently has one or more pages without any fields. Blank pages are a result of Page Breaks that are positioned as the first or last field in the form or right after each other. Please adjust the Page Breaks.\",\"ValidateFormMissingProductLabelTitle\":\"Missing Product Label\",\"ValidateFormMissingProductLabel\":\"This form has a Product field with a blank label. Please enter a label for every Product field.\",\"ValidateFormMissingProductFieldTitle\":\"Missing Product field\",\"ValidateFormMissingProductField\":\"This form has an Option field without a Product field. You must add a Product field to your form.\",\"FormulaIsValidTitle\":\"Success\",\"FormulaIsValid\":\"The formula appears to be valid.\",\"FormulaIsInvalid\":\"There appears to be a problem with the formula.\",\"DeleteFormTitle\":\"Confirm\",\"DeleteForm\":\"You are about to move this form to the trash. &#039;Cancel&#039; to abort. &#039;OK&#039; to delete.\",\"DeleteCustomChoice\":\"Delete this custom choice list? &#039;Cancel&#039; to abort. &#039;OK&#039; to delete.\",\"FieldAdded\":\"&nbsp;field added to form\",\"nameFieldDefaultPrefixes\":[{\"text\":\"Dr.\",\"value\":\"Dr.\"},{\"text\":\"Miss\",\"value\":\"Miss\"},{\"text\":\"Mr.\",\"value\":\"Mr.\"},{\"text\":\"Mrs.\",\"value\":\"Mrs.\"},{\"text\":\"Ms.\",\"value\":\"Ms.\"},{\"text\":\"Mx.\",\"value\":\"Mx.\"},{\"text\":\"Prof.\",\"value\":\"Prof.\"},{\"text\":\"Rev.\",\"value\":\"Rev.\"}]};\t\t\t<\/script>\n            \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Progress Pharmacy is your pipeline into a NETWORK of the most trusted pharmacies for some of the most competitive pricing on the most sought after solutions for: Weight Loss &amp; Body Composition Gut Health &amp; Immune Dysregulation Tissue Repair &amp; Regeneration Cognitive Function &amp; Stress Management Longevity &amp; Performance And More! &quot;*&quot; indicates required fields This field is hidden when viewing the formSource Provider Information Provider Name* First Last Provider Email* Enter Email Confirm Email Username* Password* Enter Password Confirm Password Strength indicator Your password should contain a combination of letters, numbers, and symbols. Provider Phone* Email and SMS Consent <\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-568","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Provider Registration in West Palm Beach, FL | Progress Pharmacy<\/title>\n<meta name=\"description\" content=\"Provider Registration - Progress Pharmacy is your pipeline into a NETWORK of the most trusted pharmacies for some of the most competitive pricing on the most sought after\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/progresspharmacy.com\/provider-registration\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Provider Registration in West Palm Beach, FL | Progress Pharmacy\" \/>\n<meta property=\"og:description\" content=\"Provider Registration - Progress Pharmacy is your pipeline into a NETWORK of the most trusted pharmacies for some of the most competitive pricing on the most sought after\" \/>\n<meta property=\"og:url\" content=\"https:\/\/progresspharmacy.com\/provider-registration\/\" \/>\n<meta property=\"og:site_name\" content=\"Progress Pharmacy\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ProgressPharmacy\/\" \/>\n<meta property=\"article:modified_time\" content=\"2025-11-27T09:59:45+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/progresspharmacy.com\/wp-content\/uploads\/2024\/08\/logo.png\" \/>\n\t<meta property=\"og:image:width\" content=\"172\" \/>\n\t<meta property=\"og:image:height\" content=\"49\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/progresspharmacy.com\\\/provider-registration\\\/\",\"url\":\"https:\\\/\\\/progresspharmacy.com\\\/provider-registration\\\/\",\"name\":\"Provider Registration in West Palm Beach, FL | Progress Pharmacy\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/progresspharmacy.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/progresspharmacy.com\\\/provider-registration\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/progresspharmacy.com\\\/provider-registration\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/progresspharmacy.com\\\/wp-content\\\/uploads\\\/2024\\\/08\\\/logo.png\",\"datePublished\":\"2024-05-28T19:07:09+00:00\",\"dateModified\":\"2025-11-27T09:59:45+00:00\",\"description\":\"Provider Registration - Progress Pharmacy is your pipeline into a NETWORK of the most trusted pharmacies for some of the most competitive pricing on the most sought after\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/progresspharmacy.com\\\/provider-registration\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/progresspharmacy.com\\\/provider-registration\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/progresspharmacy.com\\\/provider-registration\\\/#primaryimage\",\"url\":\"https:\\\/\\\/progresspharmacy.com\\\/wp-content\\\/uploads\\\/2024\\\/08\\\/logo.png\",\"contentUrl\":\"https:\\\/\\\/progresspharmacy.com\\\/wp-content\\\/uploads\\\/2024\\\/08\\\/logo.png\",\"width\":172,\"height\":49,\"caption\":\"Progress Pharmacy\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/progresspharmacy.com\\\/provider-registration\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/progresspharmacy.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Provider Registration\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/progresspharmacy.com\\\/#website\",\"url\":\"https:\\\/\\\/progresspharmacy.com\\\/\",\"name\":\"Progress Pharmacy\",\"description\":\"Pharmacy in West Palm Beach, FL\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/progresspharmacy.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Provider Registration in West Palm Beach, FL | Progress Pharmacy","description":"Provider Registration - Progress Pharmacy is your pipeline into a NETWORK of the most trusted pharmacies for some of the most competitive pricing on the most sought after","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/progresspharmacy.com\/provider-registration\/","og_locale":"en_US","og_type":"article","og_title":"Provider Registration in West Palm Beach, FL | Progress Pharmacy","og_description":"Provider Registration - Progress Pharmacy is your pipeline into a NETWORK of the most trusted pharmacies for some of the most competitive pricing on the most sought after","og_url":"https:\/\/progresspharmacy.com\/provider-registration\/","og_site_name":"Progress Pharmacy","article_publisher":"https:\/\/www.facebook.com\/ProgressPharmacy\/","article_modified_time":"2025-11-27T09:59:45+00:00","og_image":[{"width":172,"height":49,"url":"https:\/\/progresspharmacy.com\/wp-content\/uploads\/2024\/08\/logo.png","type":"image\/png"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"5 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/progresspharmacy.com\/provider-registration\/","url":"https:\/\/progresspharmacy.com\/provider-registration\/","name":"Provider Registration in West Palm Beach, FL | Progress Pharmacy","isPartOf":{"@id":"https:\/\/progresspharmacy.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/progresspharmacy.com\/provider-registration\/#primaryimage"},"image":{"@id":"https:\/\/progresspharmacy.com\/provider-registration\/#primaryimage"},"thumbnailUrl":"https:\/\/progresspharmacy.com\/wp-content\/uploads\/2024\/08\/logo.png","datePublished":"2024-05-28T19:07:09+00:00","dateModified":"2025-11-27T09:59:45+00:00","description":"Provider Registration - Progress Pharmacy is your pipeline into a NETWORK of the most trusted pharmacies for some of the most competitive pricing on the most sought after","breadcrumb":{"@id":"https:\/\/progresspharmacy.com\/provider-registration\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/progresspharmacy.com\/provider-registration\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/progresspharmacy.com\/provider-registration\/#primaryimage","url":"https:\/\/progresspharmacy.com\/wp-content\/uploads\/2024\/08\/logo.png","contentUrl":"https:\/\/progresspharmacy.com\/wp-content\/uploads\/2024\/08\/logo.png","width":172,"height":49,"caption":"Progress Pharmacy"},{"@type":"BreadcrumbList","@id":"https:\/\/progresspharmacy.com\/provider-registration\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/progresspharmacy.com\/"},{"@type":"ListItem","position":2,"name":"Provider Registration"}]},{"@type":"WebSite","@id":"https:\/\/progresspharmacy.com\/#website","url":"https:\/\/progresspharmacy.com\/","name":"Progress Pharmacy","description":"Pharmacy in West Palm Beach, FL","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/progresspharmacy.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/progresspharmacy.com\/wp-json\/wp\/v2\/pages\/568","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/progresspharmacy.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/progresspharmacy.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/progresspharmacy.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/progresspharmacy.com\/wp-json\/wp\/v2\/comments?post=568"}],"version-history":[{"count":10,"href":"https:\/\/progresspharmacy.com\/wp-json\/wp\/v2\/pages\/568\/revisions"}],"predecessor-version":[{"id":3824,"href":"https:\/\/progresspharmacy.com\/wp-json\/wp\/v2\/pages\/568\/revisions\/3824"}],"wp:attachment":[{"href":"https:\/\/progresspharmacy.com\/wp-json\/wp\/v2\/media?parent=568"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}