Register as a New Customer for Online Shopping

Please specify in what capacity you are registering for Online Shopping. Note that Omnisurge is a wholesaler and our products are sold in bulk cases, not individually. If you are a Private Individual or you do not want to purchase in bulk please go to http://medicalonline.co.za/.
Please enter your First Name.
Please enter your Surname.
Please enter the name of the Medical Practice, Facility, Company, Retailer, Wholesaler, NGO/NPPO, or Entity you represent.
This will be used for all correspondence, orders, confirmations, etc.
Please record this user name and keep it in a safe, easy to remember place for all future logins.
Please record this password and keep it in a safe, easy to remember place for all future logins.
Please choose the Warehouse nearest to your location. This is where all your orders will be sent to.
Please supply a primary contact number (use numbers only with no spaces inbetween).
This is the Address where your orders must be delivered to.
This is the Address to be used on the Invoices of your orders.