Review and print the form below. Then, return to the task page for further instruction.
Step 1: Review the document below and check for any errors relating to your practice name or information. If there are any errors, contact your Practice Development Manager.
Step 3: Click print form to print copies of the agreement.
Step 3: Return to the previous task page for further instructions.
Old Account Information
|Address:||, , , ,|
Dear, Vendor -
Account taken over with effect from:
New Account “Bill to” Name: –
Please be advised that the above Dental Practice’s technical health care services business has been acquired by (“Dental Corporation”) as per date indicated above. The ordering of all goods and services will be done by Dental Corporation operating from the existing practice location.
All deliveries and invoices should continue to be sent directly to the Dental Practice address.
It is crucial that the account details are amended to reflect the new corporate name, , and that all future invoices reflect the new business name “ –
Dental Corporation will be coordinating payment of all authorized invoices via Electronic Funds Transfer (EFT). If your company is not currently doing business (or not receiving electronic payments) with Dental Corporation, please complete the attached form and forward via email to email@example.com. All queries regarding payment should be directed to dentalcorp Accounts Payable at the same email address, and not to the Practice.
If you have any queries regarding the above, or any other matter, please do not hesitate to contact the Accounts Payable Team at our Support Centre by calling 416.558.8338 or via email at firstname.lastname@example.org.
Practice Partner Signature
DENTAL CORPORATION OF CANADA INC. - ACCOUNTS PAYABLE TEAM
Suite 1420 – 21 St. Clair Avenue East, Toronto, ON M4T 1L9
TEL: 416.558.8338 | FAX: 647.347.7925
Please DO NOT send INVOICES to the address above. All invoices should be sent to the practice directly.
|New Account Number:|
New Vendor Details:
|Accounts Receivable Contact:|
IMPORTANT: Banking Details for Electronic Transfer purposes only
PLEASE ATTACH VOIDED CHEQUE TO ENSURE ACCURACY OF YOUR PAYMENT