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North America

+1 (800) 258 5361 or +01 614 210 7300

Online Support

International Distributors

ics@smiths-medical.com

Australia

+61 (2) 9634 9200

sma.sales@smiths-medical.com

Austria

+43 (0)1 8906444 - 0

office.austria@smiths-medical.com

Belgium/Luxembourg

+32 (0)2 704 49 00

Belgium@smiths-medical.com

Denmark

+45 70272090

order.danmark@smiths-medical.com

France

+33 (0)1 58 42 50 51

service.commandes@smiths-medical.com

Germany

+49 (0)89 242959 - 0

bestellung@smiths-medical.com

India

+91-22-28705210

csindia@smiths-medical.com

Ireland

+35 31 29 41 13 3

Ireland.customer.service@smiths-medical.com

Italy

+39 0773 4084350

customerservice.italia@smiths-medical.com

Netherlands

+ 31 (0)73 528 50 50

nederland@smiths-medical.com

Portugal

+351 22 532 30 10

clientes@smiths-medical.com

Sweden

+46 859477250

order.sweden@smiths-medical.com

Switzerland

(0) 41 43 388 62 00

info@smiths-medical.ch

Spain

+34 93 363 84 00

comercial@smiths-medical.com

UK

+44 (0)845 850 0445

ukcs@smiths-medical.com

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New Customer Information

Company Name

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Account Number

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Shipping Address

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State:

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Method of Shipment

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Sales Order Acknowledgements

Are sales orders acknowledgements required?

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If yes, by fax, email or both?

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Will This Be A One-Time Purchase:

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If not, what is the estimated annual purchase amount?

What is the first order value?

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Is Your ERP System EDI or iStore Compatible

Is your ERP system EDI or iStore compatible?

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EDI / iStore Contact Name:

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New Customer Account Credit Application

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Please upload a copy of the first page of the registration certificate of the chambers of commerce:

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Application Consent

Submission of this form does not guarantee an account. A customer service representative will be in touch shortly with more details of your account setup.

New Customer Account Form Italy France

Build a Brochure

North America

+1 (800) 258 5361 or +01 614 210 7300

International Distributors

Australia

+61 (2) 9634 9200

Austria

+43 (0)1 8906444 - 0

Belgium/Luxembourg

+32 (0)2 704 49 00

Denmark

+45 70272090

France

+33 (0)1 58 42 50 51

Germany

+49 (0)89 242959 - 0

India

+91-22-28705210

Ireland

+35 31 29 41 13 3

Italy

+39 0773 4084350

Netherlands

+ 31 (0)73 528 50 50

Portugal

+351 22 532 30 10

Sweden

+46 859477250

Switzerland

(0) 41 43 388 62 00

Spain

+34 93 363 84 00

UK

+44 (0)845 850 0445