Paragard Direct™ | Order the Paragard® IUD


New Account Registration
To place an order, you must have an account established with ParaGardDirect. To establish an account, please complete the online ParaGardDirect Business Application located on the Forms page and submit to us with a copy of your state license. We must have a signature on the application form and a physical copy of thelicense. Once you have established an account with ParaGardDirect, a web account will be created for you. ^� Existing ParaGardDirect Customers Requesting Online Access If you currently have a ParaGardDirect account and would like to begin purchasing products online, please fill out the form below and click submit when complete. New web accounts will be created by the close of business on the next business day.
Fields marked with * are required.
First Name *
Last Name *
User ID *	Your User ID must be at least 5 characters in length and will be required each time you log into the site. Please select a name that you can remember. Please keep this information in a secure location for future reference.
Password *	Your Password must be at least 6 characters in length and will be required each time you log into the site. This password should be a combination of letters and numbers that only has significance to you. Password must have at least one numeric value.
Phone *
Fax
Email *
Password Question *	If you forget your password, the question you have entered above will be used to verify your identity.
Password Answer *
Primary Account *
Additional Account Numbers (one per line)

Paragard^® is a registered trademark, and Paragard Direct^TM is a trademark of CooperSurgical, Inc.