Register: New Customers

If you are not currently a Vital Medical Supplies customer, please fill in the Account Application Form.

Please ensure hard copies are signed and then sent to us (along with required documentation) by fax: 1300 557 631 or scanned and emailed to database@vitalmed.com.au

Existing Customers

If you are an existing customer and would like to set up an online account, please fill in the Register for Online Account Form below and we'll create your account within 48 hours. The system will support logins with multiple accounts, please advise these in the Message field below. You will receive an email confirmation once your account has been completed.

Register for Online Account

First Name

Last Name

Company Name

Company Address

Department

Account Number

Phone Number

Email Address

Message

I would like to receive Special Offers and Newsletters via email.

Terms & Conditions

I agree to Vital Medical Supplies Terms & Conditions.

EBOS Group Australia Pty Ltd (“Vital Medical Supplies”) collects your personal information (PI) for the purposes of responding to your query, including to provide you with information about Vital Medical Supplies products and services. For these purposes, Vital Medical Supplies may disclose your PI to our related bodies corporate and third parties contracted to us. If you do not provide this information, we may not be able to respond to your query. Our Privacy Policy contains further information on how we collect, hold and use your PI.

I consent to my information being collected and have read and understood the Privacy Policy Yes