Get Merck New Drop Ship Request Form 2001-2025

Filling out the Merck New Drop Ship Request Form online can streamline your ordering process. This guide provides clear and detailed instructions for each section of the form, ensuring a smooth experience for all users.

Follow the steps to complete your Merck New Drop Ship Request Form successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the Merck account number and account name at the top of the form. Ensure that you provide accurate and complete information.
3. Enter the address details, including street address, city, state, and zip code, for the location you are requesting the drop shipment.
4. Select the type of customer from the options provided, such as physician, retail pharmacy, or clinic. This will help categorize your request correctly.
5. Indicate the type of ownership as applicable, picking from options like wholesaler, non-profit, or governmental entity. You may write in other types if not listed.
6. Provide the new drop ship information, including account name and address details, similar to the previous step.
7. Fill in the contact person's information, including their days and hours of operation, phone number, fax number, and email address for follow-up.
8. List the state license number and DEA license number along with their expiration dates. Ensure these details are current to avoid processing delays.
9. If you are part of a group purchasing agency, indicate which one. This information may facilitate your order processing.
10. Answer the question regarding your interest in using a Merck internet site for account management by selecting 'YES' or 'NO'.
11. Print your name, date, and provide your signature to authenticate the form before submission.
12. Once all fields are completed, save the form, and download or print it for your records. You can then submit the completed form by mail or fax according to the instructions provided.

Complete your Merck New Drop Ship Request Form online today to streamline your ordering process.