Kimberly-Clark
Trusted Clinical Solutions*

Customer Portal Access Request


Date: 7/30/2010
 
Note: Asterisk (*) denotes a required field.
  
Are you currently purchasing directly from Kimberly-Clark?Yes  No
(If No, Customer Portal access is not available. Please contact your distributor to find out what online options are available.)

Please select the areas of the Customer Portal you would like access to:

   Order Management – Includes order status, PO acknowledgements, shipping information, invoices, and shipping discrepancy forms.
 
   Product Catalog - Includes product search, product details, and download capabilities. Also includes invoice pricing.
 
   Contract Management - Includes contract search, end user lookups, and download capabilities.
 
   Price Comparison Reports - Report shows discrepancy in KC pricing versus customer requested pricing. Only available to customers placing orders via EDI.
 
   Chargeback Management - Includes status of chargeback requests as well as ability to enter or upload chargeback or sales tracing information.
 
Company Information:


  Customer Number:
*Company Name:
*Company Street Address:
 
*Company City:
*Company State/Province:
*Company Zip/Postal:
*Company Country:
*Company Telephone Number:
Company Fax Number:
*User First Name:
*User Last Name:
*User E-mail Address:
Are there other locations in your organization that you want to have access to?  Yes No
 

All information you receive or to which you otherwise have access as part of this program shall be received and held in confidence as appropriate for your job function.

All information you receive shall be used only for the purpose of confirming your order status, your pricing, or to assist you with facility contract information.

All information you receive shall not be shared with anyone else nor used for any other purpose than those stated herein.
 
I accept:
 
  

**Please note, it may take up to two weeks to complete your request.