Eapps

Contact Details for the Imperial Health Sciences Credit Risk Department:

Telephone: + 27 12 621 4300

Fax Number: + 27 87 233 4650

Email address: newaccounts@ihs.za.com

 

Credit Application and Conditions of Agreement 
 
To avoid any possible delays from Imperial Health Sciences to process your Credit Application, the following should be noted and copies of the following documents need to be attached / submitted with the completed Credit Application Form: 
 
  • The Credit Application Form to be duly completed and signed (all 6 pages) 
  • All 6 pages to be initialed by the signatory of the Credit Application
  • Indicate the required Credit Limit per Client/Principal (page 5) 
  • Indicate whether you will be Accepting Back Orders or not Accepting Back Orders (Page 5)
  • Please Complete the Checklist on page 6 and attach/submit the application documentation with your completed Credit Application Form.
 
Companies & Close Corporations
  • Copies of Directors / Members and Shareholders Identity Documents with proof of residence.
  • Should the application form be signed by a non-principal, a resolution letter by the board is required that authorise the signatory to sign the Credit Application Form, and bind the Business / Practice to the Standard Conditions of Agreement contained in this Credit Application Form.
 
Copies of the following documents are required for verification purposes, and to comply with regulatory requirements: (As per Checklist on page 6 of the Credit Application Form)
 
1. Documents Required (All Credit Applications)
1.1 Credit Application Form duly completed and signed (6 Pages)
1.2 All 6 pages initialed by the signatory of this Credit Application
1.3 Copies of Owners/Directors ID Documents
1.4 Copy of VAT Certificate
1.5 Copy of Cancelled Cheque or copy of a bank letter, confirming the correct bank details
1.6 Copy of Company Registration Certificates (Statutory Documents)
  Please note: Should the Credit Application Form be signed by a non-principal, a resolution letter by the board is required that authorize the signatory to sign the Credit Application Form, and bind the business to the Conditions of Agreement contained in this Credit Application Form.  
2. Retail Pharmacies – Copies of the following documents
2.1 South African Pharmacy Council (SAPC) - Certificate of Recording of a Pharmacy
2.2 South African Pharmacy Council (SAPC) - Certificate of Recording of the Pharmacy owner
2.3 South African Pharmacy Council (SAPC) - Certificate of Recording of the Responsible Pharmacist
3. Wholesale Pharmacies – Copies of the following documents
3.1 South African Pharmacy Council (SAPC) - Certificate of Recording of a Pharmacy
3.2 South African Pharmacy Council (SAPC) - Certificate of Recording of the Pharmacy owner
3.3 South African Pharmacy Council (SAPC) - Certificate of Recording of the Responsible Pharmacist
3.4
Medicines Control Council (MCC)  - Licence to act as a Wholesaler of Medicines (All pages)
3.5
Department of Health Licence (DOH)
4. Medical Practitioners / Doctors /Optometrists /Dentists - Copies of the following documents
4.1 Copy of HPCSA Card (Health Professions Council of South Africa)
4.2 Department of Health Licence (DOH) - Copy of Valid Dispensing Licence (*When Applicable)
4.3 The Allied Health Professions Council of South Africa Certificate (AHPCSA) (*When Applicable)
4.4 Veterinarians – Registration Certificate of South African Veterinary Council (SAVC)
4.5 Section 22A Permit Holders – Copy of DOH Section 22A Permit  
5. Export Customers – Copies of the following documents
5.1 Ministry of Health Certificate /In Country Regulatory Documents (* When applicable)
5.2 Import/Export Licence
5.3 Proof of Business Address/Copy of Utility Bill
Please attach any additional documents to this application, or provide any additional information /additional list of Directors etc, on an official company letterhead