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Create a Veterinary Account

Complete all applicable forms below

Complete the following steps:

Step 1

New veterinary account application form

Help us get to know your business by completing our veterinary account application form.

Step 2

Controlled substances

Documentation required for purchasing controlled substances.

Step 3

Required state-specific forms

Some state laws require supplemental licensure before allowing practitioners to purchase prescription drugs.
As of March 26, please submit new application forms digitally by clicking the “Click to sign” button at the bottom of the form once it is filled in.
 
Unfortunately, we cannot process applications that are:
• Handwritten
• Include a handwritten signature
• Downloaded, filled in, and sent as a PDF via email or fax
• Photocopy of completed form
 
If you need assistance, please contact your sales rep or application@mwiah.com.
 

New veterinary account application

Complete the form that applies to your business.

Single signature application

If you are able to complete the form, sign as an authorized party for the clinic/organization, provide the licensing, and act as the guarantor (financially responsible party) for the account, you can use the single signature application.

Multi-party signature application

If you have several parties that needs to sign off on authorization, guarantor and licensing, please use this application.
 

Controlled substances

Documentation required for purchasing controlled substances

The following items are required if you intend to purchase controlled substances from MWI Animal Health:

  • DEA license
  • DEA due diligence documentation (complete all applicable forms below)

DEA due diligence documentation forms

Complete the following forms, where applicable, to fulfill your DEA due diligence documentation requirements.

Know Your Customer questionnaire

CSMP Form 590P

Ohio annual practitioner questionnaire

CSRA Form 590P (Ohio only)

 

Required state-specific forms

Some state laws require supplemental licensure before allowing practitioners to purchase prescription drugs. Below is a list of state-specific forms. 

Florida HCCE Form

CSRA Form 590P (Ohio only)

Ohio annual practitioner questionnaire

Ohio TDDD Form

Tax-exempt products

Documentation required for purchasing tax-exempt products

If you plan to purchase tax-exempt products, complete and submit the following forms with your application. 

Sales Tax Exemption forms

Wholesale account sales

Forms are based on your state.

Nexus Form

This form may be used for Alabama, Arizona, Colorado, or Louisiana.