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Complete the below order form to subscribe to the DeantalDeadBeats.com listings. You will receive a user name and password to access the listings.  This offer is only open to licensed Dentists. The subscription fee is $120.00 annually.

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Agreement - The subscription fee for $120.00 annually. Webmaster agrees to maintain these listings and make them available to subscriber. The beginning date being the date that payment is received from you. There are no refunds for unused time should you decide later that you do not want to use the service. You affirm that you are a licensed Dentist and that the information furnished above is true and correct. The information that you will be given access to is confidential information and is for your own use only for the purpose of evaluating whether or not to extend credit to potential patients. Disclosure of this information to third parties, including those whose names are listed in the database is prohibited. Sharing your user name and password is strictly prohibited also. Any violations of this agreement by you will be cause for the webmaster to terminate your access to the database with no refunds given.

You hereby agree to indemnify and hold harmless DentalDeadBeats.com, its affiliates, employees and members from and against any and all liabilities. That arises as a result of your use of or excess too DentalDeadBeats.com. By posting any information on DeantalDeadBeats.com you hear by represent and certify that all information in ant posting by you is true, actual and completed. You further agree to properly notifie Dentaldeadbeats.com of ant change to information made by you or brought to your attention

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