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Credit Application Buying Groups and Chains

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To establish an account with CooperVision Canada, just take a few minutes and complete the application below.

Please note that a home address will not be accepted for your address. Establishment of your account and its ongoing status is subject to approval by the Credit Department. Upon receipt of the completed and signed credit application, CooperVision will assign an account number and contact you with your account information.

If you need any assistance, please call 1 888.475.8555 and press 2 for the Accounting Department. Completed credit applications can be also faxed to 1 866.335.5131 or emailed to payment@coopervision.com. Click here to download a PDF version of the credit application. 

 

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TYPE OF BUSINESS (Check One)
TYPE OF PRACTICE (Check One)
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Do you have other businesses that currently purchase or previously purchased products from CooperVision Canada Corp.?
Do any other members of your family own related business that have done business with CooperVision Canada Corp.?
Does your business Export, if so do you have an export license?
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