Request Account and Pricing

In order to use the on-line shopping cart, view pricing information, or access special website promotions, you must request an on-line account and be approved by the Company. Please fill out the required fields to request a new on-line account and click Submit Request. If you need assistance when requesting an account, please click on the Live Support link below and you will be immediately connected to Customer Service Support. You may also call Customer Service at 800-233-5469 if you encounter any difficulties. Live Support and Customer Service is available Monday-Friday 8:30-6:30 CST.

For security purposes, it may take as much as 24 hours to verify the information submitted. OCuSOFT will e-mail you when your account is approved for on-line ordering.


Billing Information     Bold = Required
Business Name:
Contact:
Address:
City: State: Zip:
Phone:
Taxable ?
Yes
Tax Rate : %
Shipping Information
Same as  above:
Business Name :
Address:
Attention:
City: State: Zip:
Phone: Fax:
Email Contact Information
Email:
Online Account Information
Desired Username:
Choose a Password:
Confirm Password:
 

 


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