VETPETFORM

Veterinary Medication Form

Important Notice: The item you have selected is a veterinary medication. To purchase it, you are required to complete a special form. Please ensure that you provide accurate and complete information about your pet to ensure the correct selection of the medication. Thank you for caring about your pets' health!

What species is the pet?

What is the pet's name?

What is the pet's date of birth?

What is the pet's weight? (KG)

What is the pet's sex?

Male

Female

Is the pet neutered?

Yes

Is there a chance the pet could be pregnant?

Yes

Does the pet have any allergies? If yes please specify.

Is the pet on any medication? If yes please specify.

Tick this box if pets live at a different address than billing address

Enter pets' address

Enter your email address

I am aware of the need to read all of the instructions and warnings on the leaflets inserted in the packaging and I will do so before any handling and administration

I am aware that some products cannot be used during pet pregnancy or pet lactation and will check before administration

I am aware that some products may react with other treatments if the animal is on medication and will check with my vet before administration

I have not had any problems using this product on this animal / these animals before

I confirm the above