V.A.C.® Therapy Customer Portal Request Form

First Name *

Last Name *

Business Email *

Business Phone Number *

Job Role *

Other Job role

Medical Specialty

Hospital/Facility Name *

Hospital/Facility Address *

Hospital(s) requesting access to (Provide Hospital Full Name) *
If multiple campuses, including community health centres, are required, list each campus separately

Extra features (select all that apply)

Access to online tracking of rentals, consignments and managed fleet

Access to online consignment activations

Access to request new rental deliveries

Access to request ward changed on existing rental order

Access to request cease rental on existing rental orders

Please provide details of your direct manager or above for approval of your application
Hospital Approver Name *

Hospital Approver Position *

Hospital Approver Email Address *

Hospital Approver Phone Number *

Country/Region *

State or Province

Requestor Consent and Obligations:
I understand that my personal information may be held by third parties overseas for business operational, support and continuity purposes, including by members of the Solventum group of companies, which may be located in the USA, Netherlands, Singapore, India and UK.

I understand that the Privacy Policy contains further information about these matters including how I may access or correct my personal information and make a complaint about a breach of my privacy.

I have read and understood the V.A.C.® Therapy Customer Portal Terms of Use. *

I understand that Customer Portal log on accounts will be deleted after 90 days of inactivity *

I agree that I will contact the Advantage Centre on 1300 524 822 or kcienquiriesau@solventum.com to request account access to be removed in the event my responsibilities change, I leave my organisation or otherwise no longer require access. *

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Register to access
V.A.C.^® Therapy
Customer Portal

We never stop solving for you.

Complete the form below, and we will be in touch

Register to access V.A.C.® TherapyCustomer Portal​

We never stop solving for you.

Complete the form below, and we will be in touch

Register to access
V.A.C.^® Therapy
Customer Portal