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Become a customer

To become a new customer of Össur you will need to complete a credit application (see below).
You may also call 800-233-6263 for assistance.

Please be advised that starting July 1, 2013, all RAs (Return Authorizations) that are older than 90 days will be deleted from our system. All returns must be sent to Össur immediately to ensure credits be posted on your account.

Credit Application Form

Please fill out our online credit application as thoroughly as possible so there is no delay in processing (please allow 2-3 days for processing time). Once it has been processed, you will be notified by email with your account information.

Business Owner (Sell To)

Note: Fields marked with * are requried

Key Management Members and Owners

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Billing Address (Bill To)

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Shipping Address (Ship To)

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Banking Information

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Credit References - Reference A

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Credit References - Reference B

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Payment Terms with Payment Method and Verification

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Selection and Agreement to ÖSSUR Americas offered terms
Note: Select one box as the agreed to Standard Payment Terms and Payment Method – Any changes made to this Credit application without Össur’s prior written consent shall be null and void.
We certify that all the information on this form is true and correct. We fully understand and agree to pay in accordance to our selected standard Payment Terms and Payment Method provided under the Payment Terms section. We authorize ÖSSUR Americas Inc. to contact any source necessary (including our bank credit references and any credit bureaus) to complete an evaluation of our credit and financial history and hereby request that our bank and references release information requested about our account. Any changes made to this Credit application without Össur’s prior written consent shall be null and void.

In consideration of extension of credit and establishment of a credit account applicant acknowledges liability for payment of amounts due ÖSSUR America’s Inc. If ÖSSUR America’s Inc. must take action to collect any balance owing applicant agrees to pay all reasonable costs and expenses incurred in collection including but not limited to collection fees reasonable attorney fees court costs and interest thereon at the then maximum legal rate. By signing this agreement, applicant acknowledges payment will be made on or before a 30 days from date of the invoice. The past due amounts are subject to 1.5% finance charge. By signing this agreement applicant further acknowledges that the individual signing on its behalf is authorized to do so and that applicant will be bound by such signature. JURISDICTION AND DISPUTE RESOLUTION - Any action will be through a California court and California law will apply.By entering into this (Credit Agreement) I agree to be bound by the provisions of Össur Americas Inc.'s Standard Terms and Conditions of Sale

Invoice/Statement Delivery Method: Group E-mail address preferred

Note: Fields marked with * are requried