Getting Started

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Let’s Get Started…

Don’t delay using the Amerapeutic System to streamline your workload and establish the right EMR system.  Starting at less than $2.00 a day per user of just $55.00 per month gets you a no-gimmicks, no long-term contract deal, just an easy to use web application developed from therapists just like you. Give us a call at 800-451-5351 for any questions, to schedule a demo, or to get a quote on the complete pricing before registering.

If you are ready to register, please fill out the form below with your contact and company information, please indicate the number of users and make sure to review and accept the “Terms Of Service”. We accept the following secure forms for recurring payment: Visa, MasterCard, Discover & Bank ACH Draft. Once you have submitted the registration information, one of our representatives will contact you and assist with the rest of the setup process.

Account Information

Company Name:
Contact Name:
Phone:
Fax:
E-mail:
Street Address:
City:
State:
Zip:
Number of Therapist Users:
Will you be utilizing the Billing Module:
If yes, how many Billing Users:
How many Clerical (Read-Only) Users:
I Agree to Accept the Terms of Service:

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Payment Information: *Note* No charges are being processed at this time. This information is for setup and recurring monthly charges only.
Card Holder Name:

Payment Type:
Card Number:
Billing Address:
Billing City:
Billing State:
Billing Zip:
Expiration Date:
Digital Signature: (First & Last Name)
By submitting this form you are confirming you have the authority to provide Americana Corporation with credit card information for the use of the charges mentioned in your quote for the member subscription to Amerapeutic Therapy System, unless paying by some other method.
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