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Midwest Veterinary Supply New Account Application

Instructions – Please have the following documents readily available before starting the application. You will not be able to submit the application without these documents.

NOTE: If section is not applicable please leave blank (no spaces)

  • Copy of DVM license to be uploaded (if applicable)
  • Copy of DEA license to be uploaded (if applicable)
  • DEA KYC Due Diligence Form – Required if submitting a DEA license
  • Copy of State Control License to be uploaded (if applicable)
  • Copy of State Premise Permit to be uploaded (if applicable)
  • Copy of HCCE permit for Florida applicants to be uploaded
  • Copy of TDDD license for Ohio applicants to be uploaded
  • Tax Exempt form available within the application process

Upload documents can be in the following formats: .JPG, .PNG or .PDF
(File-Size Limit: 25mb per upload)

When you are ready to start the application please click NEXT.
If you are not able to Finish the application all at once, please select Finish Later at the top of the page to send the saved application to your email for completion at a later time.
For questions regarding the online application please email online.support@midwestvet.net

EMAIL or FAX PDF Forms

Instructions for Ordering Tags by EMAIL or FAX :

  1. Select the style of tag desired by clicking one of the links below
  2. Type in your information using your computer
  3. Complete the order form
  4. SAVE the completed form to your computer / documents folder
  5. To EMAIL your order:
    1. Click on this link rabiestags@midwestvet.net to open an email and ATTACH your completed order form
  6. To FAX your order:
    1. SAVE and PRINT the completed form
    2. FAX to: 1-855-205-0576.