<PAGE> 1
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 8-A
FOR REGISTRATION OF CERTAIN CLASSES OF SECURITIES
PURSUANT TO SECTION 12(b) OR 12(g) OF THE
SECURITIES EXCHANGE ACT OF 1934
MEDIQUAL SYSTEMS, INC.
(Exact name of registrant as specified in its charter)
DELAWARE 36-3112859
(State of incorporation or organization) (I.R.S. Employer
Identification No.)
1900 West Park Drive, Westborough, Massachusetts 01581
(Address of principal executive offices) (Zip Code)
If this Form relates to the registration If this Form relates to the
of a class of debt securities and is registration of a class of
effective upon filing pursuant to debt securities and is to
General Instruction A(c)(1) please check become effective
the following box. \_\ effectiveness of a concurrent
effectiveness of a current
registration statement under
the Securities Act of 1933
pursuant to General
Instruction A(c)(2) please
check the following box. \_\
Securities to be registered pursuant to Section 12(b) of the Act:
Title of each class of Name of each exchange on which
securities to be registered each class is to be registered
None.
SECURITIES TO BE REGISTERED PURSUANT TO SECTION 12(G) OF THE ACT:
Common Stock, $.001 par value
<PAGE> 2
(Title of Class)
INFORMATION REQUIRED IN REGISTRATION STATEMENT
Item 1. Description of Registrant's Securities to be Registered
The information required by Item 202 of Regulation S-K is included
under the heading "Description of Capital Stock" in the Registrant's
Registration Statement on Form S-1 (No. 333-04883), filed with the Securities
and Exchange Commission on May 31, 1996, as amended, including any form of the
prospectus contained therein filed by the Registrant pursuant to Rule 424(b)
under the Securities Act of 1933, as amended (the "Registration Statement"),
which is incorporated herein by reference.
Item 2. Exhibits
1. The Amended and Restated Certificate of Incorporation of the
Registrant is incorporated herein by reference to Exhibit 3.1 to the
Registration Statement.
2. The Amended and Restated By-Laws of the Registrant are incorporated
herein by reference to Exhibit 3.2 to the Registration Statement.
3. A specimen copy of the certificate representing shares of the
Registrant's Common Stock is incorporated herein by reference to Exhibit 4 to
the Registration Statement.
<PAGE> 3
SIGNATURE
Pursuant to the Requirements of Section 12 of the Securities Exchange
Act of 1934, the registrant has duly caused this registration statement to be
signed on its behalf by the undersigned, thereto duly authorized.
MEDIQUAL SYSTEMS, INC.
By: /s/ William C. Price
--------------------------------
Name: William C. Price
Title: Vice President and
Chief Financial Officer
DATED: September 24, 1996
