VisionWeb Registration Form
Instructions? Click here

Business Information Customer Service: 1-800-874-6601
Business/Practice Name
Street Number
Street Name
Business Phone
Business Fax
 Eyecare Business Type: (select all that apply)
Optometrist (OD)Ophthalmologist (MD)Optician/DispenserManufacturer/Distributor

Administrator/Primary Contact
The primary contact will be the Administrator. Administrators have the ability to add/modify all account information; including user accounts, suppliers, billing information, etc. An account activation link will be sent to the e-mail address entered below. Please verify the e-mail address is correct. If the e-mail address is incorrect or undeliverable, you will be unable to log in and begin using VisionWeb.
First Name
Last Name
E-mail Address
Confirm E-mail Address
Username (see note below)
Password (see note below)
Confirm Password
Username must be between 4-20 characters in length, and begin with a letter or a number. Username may contain letters, numbers, dashes, periods, and/or underscores. Password must contain at least one uppercase, one lowercase, one digit and must be between 10 and 36 characters. Special characters are not allowed.

Yes. I have read, and agree to, the VisionWeb Terms and Conditions.
Yes. I have read, and understand, the VisionWeb Privacy Policy.
Process electronic insurance transactions to hundreds of payers from one convenient location with VisionWebs online insurance transaction processing service. Let us know if you would like to be contacted by one of our enrollment representatives by checking the box below.

Learn More About VisionWebs Insurance Transaction Processing Service.
Yes. I am interested in learning more about VisionWeb’s insurance transaction processing service. Please have a representative contact me.