To establish an account with CooperVision, please submit your credit application online by clicking below to access the form.
If you cannot access the online application, please call 1.888.475.8555 and press 2 for the Accounting department to obtain a form. Completed credit applications can be faxed to 1.866.335.5131 or emailed to firstname.lastname@example.org. A home address will not be accepted for either your bill-to or ship-to address. Establishment of your account and its ongoing status are 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.