Pom-VPS

Mandatory Information Required

Orders containing POM-VPS products will not be processed unless the form below is completed in full.

If the required information is not provided, your order will be cancelled and a £5 administration charge will be deducted.

Keeper / Owner details

Name
Please provide an email address for the invoice
Enter your phone number incase we need to contact you about your order
Full Address of Animal
Delivery Address if different
I confirm the details provided are accurate and relate to the animals being treated.
I understand a VET or RQP may contact me for more information before supply.

About your pet

eg. Dog, Cat, Rabbit, Horse
Please let us know the estimated animal weight ?
Have you used this (or similar) product before?
What are you treating with this product?

Legal Confirmation

I confirm I have read and understood the product directions and that this medicine is for my own animal(s).
Please tick this box to confirm that you have read and understood the directions for use of this product. By doing so, you acknowledge that the medicine is being purchased for your own animal(s) and that you will follow all instructions provided on the packaging and product information leaflet. This helps ensure the product is used safely and effectively, in line with the Veterinary Medicines Directorate (VMD) guidelines.

Any other information ?

You can provide us with more information if you wish.

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Your privacy is our policy.

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