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Don't want to sign up online? Download application materials here!

Group Purchasing Participation Agreement

W-9 Form (must be included with Group Purchasing Participation Agreement)

Supplemental Information Application Form

Vaccines & Vendor Forms


Join as a Member!

This membership option is for any physician or healthcare provider practicing anywhere in the United States.

(Learn more about this Membership)


Not Ready to Join?

If you would like to review CCPA Purchasing Partners' sample vaccine and/or vendor pricing prior to joining, you are welcome to do so! Please complete our Acknowledgement of Confidentiality and Non-disclosure Obligations (be sure to select which vaccine/vendor pricing you would like to receive) and we will email or fax it to your practice!

Or if you feel you need more information about our organization prior to beginning our application process, please feel free to contact us! we will respond to your inquiry within 24 hours.