Product Reg Form

 

 

 

Product Registration Form

 

 

 

 

 

Thank you for your interest in INTACTA’s products. To register your product please fill out the following form.

You will also receive a userid and password that will give you access to the INTACTA web site online support forums..

If you encounter any difficulties you may also contact INTACTA directly at 404-880-9919.

 

 

 

*Required Fields

 

 

 

 

*First Name:

 

*Last Name:

 

*Company:

 

*Title:

 

*Street Address1:

 

Street Address2:

 

*City:

 

*State:

 

*Postal Code:

 

*Country:

 

*Telephone:

 

*Email:

 

 

 

 

INTACTA Bridgeway Express - HealthCare Edition v1.5

 

Registration No:

 

 

 

 

INTACTA Bridgeway - HealthCare Edition v1.5

 

 

Registration No:

 

 

 

 

 

INTACTA.CODETM SDK Edition v5.1

 

 

Registration No:

 

 

 

 

 

 

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