Amalgam Bucket

Register a new Amalgam Bucket

Office Details Enter office information

Welcome to Crosstex DocHub, your one-stop center for amalgam separator canisters and amalgam buckets recycling. To get started, please create a profile by following the process. If you already have a profile, please sign into your account using the menu on the left.

* Office Name

* Dentist Name

* Primary Contact

* Primary Email

* Phone

Please note that if you would like to add more than one amalgam separator to your profile, fill out step 1, continue to step 2 to sign in and then add your additional separator.

Sign-Up / Sign-InEnter your Sign-in details

* Email Address

* Password

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Business Address Enter business address

Please enter the business address. The information entered here will be replicated on the certificates related to this account. Please be sure to verify the address before proceeding.

* Line 1

Apt / Unit / Suite

* City

* State

* Zip Code

Zip 4

Lid Code of the Amalgam BucketEnter product details

Please enter valid serial numbers. The serial numbers entered here will be replicated on the certificates related to this account. Please contact Crosstex at (888) 276-7783 or Crosstex@crosstex.com with any queries.

* Lid Code of the Amalgam Bucket ( e.g. 9xxxx or CTABxxxx )

* Date Installed

Dealer Name

Dealer Rep Email

Dealer Rep Name

Would you like to receive an email reminder to order a new Amalgam Bucket?

Yes No

Note that an automatic reminder will be sent 11 months from the install date.

Would you like to be added to the Crosstex mailing list for product updates and the latest compliance news?

Yes No

	Line1	Line2	City	State	ZipCode	Zip4	Address Class