HomeAgain Online Ordering, powered by Merck Animal Health eShop ACCOUNT DETAILS:*Denotes required fields.account_1(Required)account_address_1(Required)account_address_2account_city(Required)account_state(Required)Account State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingaccount_zip(Required)Are the above Account Details correct?correct_info_account(Required) Yes No If the information is incorrect, please select No and finish completing the form. A customer support representative will contact you for additional information.ONLINE SHOPPER DETAILS:You must have an authorized online shopper in order to purchase HomeAgain online. An online shopper is someone who is authorized to make purchases on behalf of your account. This could be a veterinarian, practice manager or another trusted team member. By designating authorized online shoppers, we ensure that orders are placed securely and only by approved individuals. *Denotes required fields. firstname__shopper(Required)lastname__shopper(Required)email__shopper(Required) title__shopper(Required)Online Shopper Title*Front Office StaffOffice/Practice ManagerOwner/PrincipalPurchaserVeterinarianVet TechnicianOncologistphone__shopper(Required)ONLINE PAYER DETAILS: An online payer is the person responsible for handling payments on behalf of your account, often someone in finance or accounts payable. Assigning a designated online payer ensures that all invoices and payments are managed efficiently by an approved team member. This helps keep the purchasing process smooth and reliable, so you can focus on providing care without delays.Please note that a designated online payer is not required for shelters and non-profits to complete the eShop registration process. Are the Online Shopper and Online Payer details the same?correct_info_shopper(Required) Yes No If NO, please fill out the online payer information belowpayer__firstname(Required)payer__lastname(Required)payer__email(Required) payer__title(Required)Online Payer Title*Front Office StaffOffice/Practice ManagerOwner/PrincipalPurchaserVeterinarianVet TechnicianOncologistpayer__phone(Required)Form Submitted By:Please enter the name and email address of the person completing this form. This will aide our Customer Care team in processing and responding.submittedby_firstname(Required)submittedby_lastname(Required)submittedby_email(Required)PhoneThis field is for validation purposes and should be left unchanged. Δ
