New Clinic Online Registration | Victor Medical Company

Company Name: *

First Name: *

Last Name: *

Email Address: *

Phone: *

Ext.:

Fax:

Address 1: *

Address 2:

City: *

State: *

Zip/Postal Code: *

Do you need to purchase supplies and have access to more than 1 clinic?

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Please fill this form out if you currently have a regular Victor Medical Account and need a Victor Medical Online Account. If you do not have a regular Victor Medical Account you will need to set that up with our Accounting Department before we can issue you an online account. Please call 800-888-8908 and ask for Camaron. We only sell to licensed veterinarians not to the general public. Thank you!

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