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Request Online Access

STEP 1 of 3 - Enter Profile Information

Place your orders online 24 hours a day, 7 days a week
If you are an Optum Compounding Services customer, signing up is easy:

  1. Enter your profile information
  2. Enter your practice information
  3. Submit your request - we will get back to you within 48 hours

Please enter your profile information so that we can follow up with you regarding your account request.

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(Must contain 6 - 16 characters, uppercase and lowercase letters, and at least 1 number or special character)
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Passwords do not match.
This field is required. Phone number must be 10-digits.
Must be a number with no spaces.
Double check the format.

You will be entered into our email updates.

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Practice Information

STEP 2 of 3 - Enter Provider Information

Please enter information for each company/hospital you will be ordering for. If you need to add multiple companies/hospitals, you may do so on the next page.

{{cust.PracticeName}} - {{cust.PracticeAddress}}

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Only Letters, numbers, dashes and 8 or less characters.
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This field is required. Zip Code must be 5 digits.
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Review and Submit

STEP 3 of 3 - Review Your Information

Please enter information for each company/hospital you will be ordering for. If you need to add multiple companies/hospitals, you may do so on the next page.

Profile Information Edit

Full Name: {{vm.account.FirstName}} {{vm.account.LastName}}

Phone: {{vm.account.PhoneNumber}}

Email: {{vm.account.EmailAddress}}

Fax: {{vm.account.FaxNumber}}

Practice Information

{{cust.PracticeName}} - {{cust.PracticeAddress}}

Submission Successful!

Thank you for your online access request for the SourceB portal. Our team will evaluate the information you have included in your request. You will be informed of the results of their evaluation within 2 business days.

If you have immediate needs, please email  A VL-OpthoSales@optum.com.