|
JOHNSON & JOHNSON GATEWAY® Commerce Registration FormThis site allows you to purchase our products and services online. We will use the information you provide to: process and ship your order (including disclosing your name and address to fulfillment houses and delivery services such as UPS and USPS); contact you about the status of your order; create an account for later use so that you do not need to re-enter the information for each subsequent order; and, as otherwise indicated by our site’s Privacy Policy. By clicking on the "Submit" button below, you consent to the combinations of anonymous and personally identifiable information whenever you use the site as a registered visitor and agree that the information you provide will be governed by our site’s Privacy Policy To use this site and access your facility's information herein, you must have appropriate authorization from your facility, which must have an account with Johnson & Johnson Health Care Systems, Inc. (JJHCS). If your facility lacks a JJHCS customer number, please complete and submit a JJHCS Account Registration Form.
If your facility already has a JJHCS customer number, we ask that you register to use this site by completing the on-line form provided below. To utilize this site, please ensure that you provide all required information when completing the form. Additionally, failure to provide the optional information requested in the form could limit our ability to customize your site experience - but should not prevent you from using most of our site features.
By submitting your information in this form, you agree that such information will be governed by our Privacy Policy. You may change or delete your registration information at any time by using the User ID and password that are set up during the registration process.
Please enter your information in the form below and hit the "Submit" button. Once your registration is submitted and processed, you should receive your user ID and password electronically within two business days.
This form should not be used for emergencies. In case of an emergency, please call us toll free at 1-866-JNJ-GATE (1-866-565-4283). |
|
|
| * Required fields are marked with an asterisk |
| Salutation: |
|
| First Name* |
|
| Last Name* |
|
| Title* |
|
| Organization* |
|
| Department* |
|
| Division |
|
|
| Contact Information |
|
| Business Address Line 1* |
|
| Business Address Line 2 |
|
| City* |
|
|
State/Province*
|
|
| Zip Code* |
|
|
|
Phone Numbers*
|
|
|
| Email Updates |
|
You will receive email confirmations for orders placed via the JOHNSON & JOHNSON GATEWAY®
Commerce web site. Additionally, we would like to send you email updates on late breaking news and information about our web site.
|
|
| Primary Business Email* |
|
| Secondary Business Email |
|
|
|
Email updates*
|
Yes, please send me email updates
No, don't send me email updates
|
|
You can also be notified via email when new statements are posted to your account. If you would like to receive email notifications when new statements have been posted, please check the following box.
|
| |
| Statement Notifications |
Yes, I would like to receive email notifications when statements are posted. |
|
|
| JJHCS Account Numbers |
You must enter a valid account number to receive a user ID and password.
If you do not know your account number, please check with your facilities purchasing department before submitting this form.
If you are a participating Johnson & Johnson company's Sales Representative you can enter account 50000.
|
|
| Default Account Number* |
|
|
Additional Account Numbers
|
|
|
|
| J&J Sales Representatives/Brokers |
|
Johnson & Johnson Operating Companies' sales representatives, brokers, etc. should enter their World Wide ID in the box below and select their corresponding Operating Company.
|
|
|
|
|
| User Privileges |
|
If no privileges are selected below, this account will automatically default
to only allow access to the product catalog, and the ability to create Order Templates.
|
|
|
Privileges
|
|
|
|
If you are requesting the Place Order privilege, please fill in the following section.
|
|
Are you an authorized buyer for the accounts listed on the registration?
|
Yes, I am an authorized buyer.
No, I am not an authorized buyer.
|
| Supervisor Name |
|
| Supervisor Phone Number |
|
|
| Other Information |
|
How did you hear about
www.jnjgateway.com/commerce?
|
|
|
|
|
|
|
|