Clint Pharmaceuticals: Customer Create

Note: If you have placed an order with Clint Pharmaceuticals before, you already have a registered account in our online system.

Need help accessing your account? Email Us or call 800-677-5022 to obtain your Log-In and Password information.

4 Easy Setup Steps

Create an online account to place web orders, or call 800-677-5022 (Initial order by credit card only, then terms are available on subsequent orders)
Download and complete the attached Customer Application
Send photocopy of DEA certificate (and Medical license for Idaho customers) by e-mail: customercare@clintpharmaceuticals.com or by fax 800-341-6440
When placing your initial online order, please note that the order will NOT be processed until steps 2 and 3 have been completed. For questions, please call Customer Care at 800-677-5022

Email Address

Password

DEA Number

If you have an HIN number instead of a DEA number, please call customer care at 800-677-5022

DEA Expiration Date

Email Address

Phone Number

First Name

Last Name

Professional Title

Company

Address

Address 2

City

State/Province

Country

Zip/Postal Code

Billing Information Same as Shipping

Email Address

Phone Number

First Name

Last Name

Professional Title

Company

Address

Address 2

City

State/Province

Country

Zip/Postal Code

Create Your Account