All professionals or professional organisations ordering from Fagron must complete this account application form. It is required by law to capture your profile, validate account authenticity and keep record of transactions.

Professionals and professional organisations can choose between a 30-day credit account or a prepaid account.

30-day accounts are subject to credit approvals which can take up to 14 days. Credit is not provided on prepaid accounts.

If you prefer a 30-day account, Fagron will process your initial order(s) on prepaid terms to avoid supply delays. Once the relevant credit checks are confirmed your prepaid account will be upgraded to a 30-day account with an assigned credit limit.

Incomplete application forms and/or submissions of forms without the required supporting documents will delay the application process significantly. All the sections in this application form must be completed and all the relevant supporting documentation must be supplied for an account to be processed.

Applicants must submit copies of all the supporting documents requested. Click next to view the list of profession specific supporting documents.

Do not leave any sections of the form incomplete. All sections must be completed.

Initials & signatures must be provided in full where indicated.