Home Professionals Setting up an ESCO Account
Signing up your practice to work with ESCO is easy, and FREE!
To become an ESCO Practitioner please complete the following:
*Required
Practitioner Information
*Office Name:
*Contact Person:
Title:
*Address
*City:
*State: *Zip:
*Phone:
Fax:
Email:
Website:
Type of Office (Check all that Apply)  *Check at least one
Private Practice   Clinic
ENT   Nursing Home
Hospital   Non-Profit
University School   Corporate Affiliate
*Are there branch offices you would like to set up?
Yes (ESCO will contact you to complete the process.)
No
Or call us at 1-800-992-3726 or email us at info@earserv.com
Mon - Thur:  7:30 a.m. - 4:30 p.m. CST
Friday:  7:30 a.m. - 2:00 p.m. CST
Phone: 1-800-992-3726     Fax: 763-559-4247     Email: info@earserv.com
Mail:  ESCO • 3215 Fernbrook Lane North • Plymouth, MN 55447-5325
©2012