Local Membership

We are Dedicated to Your Success

If you would like access to valuable group purchasing benefits, a 10% discount on veterinary-experienced business services, and invitations to low- to no-cost CE opportunities, become a Veterinary Hospitals Association member today! To get started, please complete the form below and a representative of VHA will be in touch shortly.

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Apply for Local VHA Membership

Company Information

Clinic Name(*)

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Clinic Address(*)

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Clinic City(*)

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Clinic State(*)

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Clinic Zip Code(*)

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Clinic Phone Number(*)

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Clinic Fax Number

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General Clinic Email(*)

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Clinic Website

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Date Established

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Corporate Structure(*)

Individual

Partnership

Corporation

Limited Liability Company

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Company Federal ID # (if applicable)

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Division/Subsidiary Of

Name

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Address

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City

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State

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Zip Code

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Phone Number

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Additional VHA Services

In addition to group purchasing benefits, VHA also offers members ethical cremation and veterinary-experienced business services. Please indicate if you are interested in learning more about either of these services.

Please note: VHA Cremation Services are only available at this time to clinics on established VHA delivery routes.

Would you like additional information about VHA Cremation Services?

Yes

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Would you like additional information about VHA Business Services?

Yes

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Bank Information

Name of Bank(*)

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Address(*)

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City(*)

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State(*)

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Zip Code(*)

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Phone Number(*)

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Fax Number

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Trade References

Company Name(*)

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Address(*)

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City(*)

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State(*)

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Zip Code(*)

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Phone Number(*)

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Fax Number

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Company Name

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Address

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City

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State

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Zip Code

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Phone Number

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Fax Number

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By affixing their signatures below, the undersigned (or if a corporation, partnership, or limited liability company the authorized officer/agent) agrees that:

For the purpose of obtaining merchandise/equipment from Veterinary Hospitals Association, the foregoing statements in writing are accurate and made knowing that Veterinary Hospitals Association in relying upon the same should credit be extended. It is further understood that the information as supplied is confidential and shall be regarded as continuous until another credit application is substituted for it and the firm listed agrees to inform veterinary Hospitals Association of any material change in their financial status or ownership.
To pay when due all invoices from Veterinary Hospitals Association and all delinquent invoice interest at 1.5% per month on outstanding balance or the maximum lawful interest rate.
This agreement shall be construed as having been delivered in the State of Minnesota, shall be construed in accordance with the laws of Minnesota and the parties hereto agree that venue shall be in the State of Minnesota and, in event of litigation arising out of this agreement, Veterinary Hospitals Association shall be entitled to reasonable attorney’s fees, costs and expenses incurred.
AUTHORIZATION TO RELEASE CREDIT INFORMATION: I/we hereby authorize you to release to Veterinary Hospitals Association, to whom credit applications have been made, all information requested pertaining to my/our Credit & Financial responsibility.

Company Name(*)

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Signature of Owner, Partner, or Authorized Officer(*)

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Signature of Owner, Partner, or Authorized Officer

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Sales Tax Exemption - Please Select One of the Following

I would like to indicate to VHA at the time of purchase if I would like an item taxed or not taxed. I have completed and enclosed the appropriate state sales tax exemption certificate and I will identify, at the time of purchase, those items that should be exempted from sales tax. VHA will collect sales tax on any items that I do not identify as exempt. If I determine, subsequent to placing my order, that items should have been taxable, I will pay the tax directly to my state. (This option allows you to choose which items you would like to be charged tax on. In general, if you are going to resell the item and charge the client tax, you would not want to pay tax on it at the time of purchase. Items that you will use in-house you would want to pay tax at the time of purchase (examples: gauze, catheters, etc.)
I would like VHA to collect tax on all items I purchase. VHA will collect tax on all items purchased unless a state tax exemption certificate is completed.
I would like VHA to exempt my account from tax on all items. I have completed and enclosed the appropriate state sales tax exemption certificate and I certify that I may resell any/all items that I purchase from VHA or cannot, at the time of purchase, identify if I will use in an exempt manner, or resell the products I purchase. Accordingly, please do not charge tax on any items that I purchase from VHA. If any additional tax is due, I will pay the tax directly to my state.

Which option do you choose?(*)

1 - Indicate Tax at Time of Purchase

2 - Collect Tax on All Items

3 - Exempt Account from Tax

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How did you hear about VHA?(*)

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Who referred you?

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Who referred you?

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How else did you hear about VHA?

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CAPTCHA(*)

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