All Fields required, unless otherwise indicated
{* #socialRegistrationForm *}
{* socialRegistration_firstName *}
{* socialRegistration_lastName *}
{* socialRegistration_emailAddress *}
{* socialRegistration_password *}
{* socialRegistration_passwordConfirm *}
{* professionalStatus *}
{* profession *}
{* specialty *}
{* licensingState *}
{* stateLicenseNumber *}
{* graduationYear *}
{* practiceName *}
{* socialRegistration_address *}
{* socialRegistration_address2 *}
{* socialRegistration_city *}
{* socialRegistration_state *}
{* socialRegistration_zipcode *}
{* socialRegistration_phone *}
{* socialRegistration_mobilePhone *}
{* promoCode *}
{* reasonCode *}
{* sampleability *}
{* socialRegistration_emailAddress *}
Will be used as your user name
{* socialRegistration_zipcode *}
{% customQuestions %}
{% customOptin %}
By submitting your information above, you agree that the information you provide will be governed by our site's Privacy Policy.
{* /socialRegistrationForm *}
{* #registrationForm *}
Enroll in the exclusive LISTERINE® Support program for member-only free patient samples, valuable resources, and dental patient education materials. Already enrolled? Log-In here.
Tell us about yourself.
Please provide us with the information requested below to get started!
All fields required
{* traditionalRegistration_firstName *}
{* traditionalRegistration_lastName *}
{* traditionalRegistration_emailAddress *}
{* traditionalRegistration_password *}
{* traditionalRegistration_passwordConfirm *}
{* professionalStatus *}
{* alternateemailaddress *}
{* school *}
{* promoCode *}
{* licensingState *}
{* stateLicenseNumber *}
{* graduationYear *}
{* profession *}
{* specialty *}
Please share your address with us so we can send you exclusive free patient samples and educational materials.
{* traditionalRegistration_address *}
{* traditionalRegistration_address2 *}
{* traditionalRegistration_city *}
{* traditionalRegistration_state *}
{* traditionalRegistration_zipcode *}
{* reasonCode *}
{* sampleability *}
{% customOptin %}
We are unable to validate your professional certification at this time. For more information, please contact our Customer Support Team at 1-866-948-6883.
The information you entered does not match our records. Please check that your name and professional certification information are correct, and click “Create Account” again.
The information you entered does not match our records. Please contact our Customer Support Team at 1-866-948-6883.
Questions? We’re here to help. Call our Professional Contact Center at 1-866-948-6883, to speak with someone directly.
By registering, you agree to receive additional transactional, marketing/promotional and sample material from the LISTERINE® Professional website. Your personal information will be used to fulfill your request for samples and/or patient education materials. Your information will be shared only with Johnson & Johnson Consumer Inc., its affiliates, and any third parties working on their behalf to fulfill your request, and will be governed by our site's Privacy Policy.
{* /registrationForm *}
{* #requirementsPostLoginForm *}
{* firstName *}
{* lastName *}
{* zipcode *}
By submitting your information above, you agree that the information you provide will be governed by our site's Privacy Policy.
{* saveButton *}
{* /requirementsPostLoginForm *}
Looks like you have an existing account with us. We have made some changes to our site and we need you to create a new password in order to login. Click send to recieve an email with instructions on how to create your new password.
{* #optinUserNewPasswordForm *}
{* optinUser_emailAddress *}
{* /optinUserNewPasswordForm *}
{* #privacyPolicyPostLoginForm *}
By clicking "Accept" below, you confirm that you have read, understand and accept our sites's Privacy Policy
{* /privacyPolicyPostLoginForm *}
All Fields required, unless otherwise indicated
Personal Information
Step 1
Will be used as your user name
By submitting your information above, you agree that the information you provide will be governed by our site's Privacy Policy.