Join Thousands of Providers Already on MAXMRJ

Complete registration in 2 minutes. Most providers choose Partner for unlimited referral processing and team access.

First Name *

Last Name *

Email *

Role *

How did you hear about us? *

Company/Provider Name *

Phone *

For urgent referral notifications

Street Address *

City *

State *

Zip Code *

Website (optional)

Primary Admin: (enter above)

Additional Team Members (optional)

Format: Full Name, email@example.com, (555) 123-4567

Additional Comments (optional)

* Required to submit

Please verify you're human before submitting the form

Complete the verification above to enable the submit button

HIPAA CompliantSecure PlatformSMS Notifications

Your information is HIPAA-secure and will only be used to contact you about MAXMRJ services.