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Thank you for visiting our website!

We're honored to be your NEW Pharmaceutical Provider.

Please follow the few simple steps below to open your new
account with us.

1)  Click here to print your CREDIT APPLICATION
2)  Fill in all requested information on the form.
3)  Sign and fax your new application with a copy of your MEDICAL or
     DEA License TOLL FREE to 1-800-341-6440.
4)  Call our office TOLL FREE at 1-800-677-5022 to confirm your application
     has been received and ask any final questions you may have.


Once you have opened your new account, follow the next few steps to place YOUR FIRST ORDER with us:

1)  Click here to print your PRODUCT ORDER FORM
2)  Provide your name and phone number.
3)  Fill in the name of your account as it appears on your Credit Application.
4)  List all desired products in the lower half with product numbers.
5)  Fax your new order TOLL FREE to 1-800-341-6440.
6)  Please indicate if you would like a return call to confirm your order.


About Your Personal Customer Number:
Your Personal Customer Number will be assigned to your new account upon receipt of your Credit Application and first order.

We Will Process Your Application & First Order IMMEDIATELY!

If you are unable to find any product you desire, please call, fax or e-mail us at the numbers provided below and we will find it for you.


*NOTE: If your browser does not allow you to print a form take one of the following steps:

1) Click here to go to the ADOBE ACROBAT READER UPDATE site.
Then install the latest version of Acrobat Reader. This will enable you to print any of the latest information off the web.

2) Or please, CONTACT US IMMEDIATELY and we will fax the appropriate form to you. You will also find both forms in the printed catalog you recieved in the mail from our office.


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   629 Shute Lane, Old Hickory, TN 37138
   E-Mail Us: <customersupport@clintpharmaceuticals.com>

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