Complete ACH payment setup
Loading...
search
search
shopping_cart
shopping_cart
account_circle
My Account
Dashboard
Logout
Login
Register
Provider Registration
Patient Registration
Visit Ortho Molecular Products
How to add a Wholesale Order
×
First, click the New Wholesale order button.
Add the products you would like to add to your packs.
Configure your packs
Complete your order
Enjoy!
How to?
Your Account
×
Click the My Account link
Access your account details
Change Payment Methods, Shipment info
Need Help?
How to Add a New Patient
×
Click the Add Patient button on your dashboard.
Enter first, last, and email for your recipients and save them to the list.
Send the recipients an invite or complete the registration form yourself.
Need Help?
×
Payment Setup
Payee Name (Name on account)
*
Address
*
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
*
Contact Name
*
Contact Phone Number
*
Email
*
Type of Account
*
Checking
Savings
Financial Institution Name
*
Financial Institution Address
*
Routing Number
*
Account Number
*
Set up payment later
Complete
You will not be able to place an order until ACH payment setup is completed.
Welcome to Ortho!
You must complete our Terms & Conditions agreements before continuing.
Continue
Decline (You will be Signed Out)
