POM-VPS / NFA-VPS

If you require POM-VPS or NFA-VPS products please complete the form below and submit it before or after ordering. This will help your order be shipped quicker.

What is the species being treated? *

Cattle – Beef
Cattle – Dairy
Sheep
Other (please fill in)

If you selected 'Other', please specify what species

Flock/Herd/CPH Number *

How many animals are being treated? *

What are the approximate weight (kg) / size of the animals to be treated? *

Have any of the animals to be treated had an adverse reaction? *

If you replied 'Yes' to the question above, please note product & type of reaction

What product was used last to treat this condition? *

Dosage per animal? (in ml) *

Please indicate the dosage per animal you plan to use.

Reason for selection of this product / active *

Why did you pick this product above others.

Are you confident to be administering this product? *

Yes
No

Will you follow the manufacturer's instructions? *

Yes
No

Are all the animals kept at the order delivery address? *

Yes
No

If you replied 'No' to the question above, please give address where animals are kept

Name *

First

Last

Phone / Contact number *

Email *

Some Questions are required by the Veterinary Medicines Directorate by ticking below, I certify all information is true and correct to the best of my knowledge. *

Agree
Do not agree

We will check your form and contact you for more information should it be required.

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