Create Account

Please provide your details to create a new account to purchase items through our eCommerce system.

Note: Your account must be activated by a Chiron admin before it can be used to log in.

Billing Details
* Username:
* Password:	Password rules: Must be 8 or more characters in length Must contain a number Must contain an uppercase character Must contain a lowercase character
* Re-type Password:
* Clinic Name:
* Clinic Email Address:
* Clinic Phone Number:
* Prescribing Veterinarian:
* Prescribing Veterinarian Licence Number:
First Name:
Last Name:
Mobile Number:
Fax Number:
URL:
Billing Phone:
Billing Email:
* Billing Address Line 1:
Billing Address Line 2:
Billing Province:
Billing Country:
Billing City:
Billing Zip/Postal Code:
Shipping Details Use billing details:

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