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Registration Info

If you have previously enrolled your practice for Shamir’s RCPV Rewards Program and received a letter detailing the “Registration Process” simply enter your Account Number and Phone Number to access your Account information.

Why am I required to Enroll?

W9 Form

Account Access
If you have already enrolled in Shamir’s RCPV program, please enter your account number and phone number to register for the RCPV site:
Account Number: Phone Number:
Practice Enrollment Information
If you have not enrolled in Shamir’s RCPV program, please enter your information below.   You will also need to manually complete a W9 form, which will be included at the bottom of the Enrollment form once you submit your information below.
Practice Info:
Practice Name:
Mailing Address:   City:   State:   Zip:
Contact Info:
Last Name:      First Name:   Title:
Phone:      Fax:   Email:
Participating Labs:
Lab Name:
Lab Account #:
Reward Recipients:
% Share of Reward:
ReCreating Perfect Vision®
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