Please click on attachment for a Print Friendly Order Form.
Medi-Vet Order Form
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Mail, Fax or Email This Form
All information submitted,
including the email address, will be kept confidential and will never be
divulged to a third party.
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Email:
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[email protected]
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WebStore:
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www.medi-vet.com
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Phone
Orders ::
Fax Orders ::
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(800) 668-9698 (Local:
985-875-7533)
(800) 640-3274 (Local: 985-875-7530)
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Postal
address ::
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Medi-Vet Animal Health
69142 Hwy 59, Suite E
Mandeville, LA 70471
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Name:
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Business Name (if applicable):
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Address:
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City, State, Zip:
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Phone:
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Email:
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Note: Prescription Medications Are
Available Only to Licensed Veterinarians and Pharmacies. Prescription medications are labeled with an "Rx"
in our store.
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Quantity
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Product
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Cost
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Total
Cost
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Louisiana
Residents add 4.0%
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Please
See Shipping/Handling Rates
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Shipping Option
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TOTAL
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Payment Method:
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Check [ ] Money
Order [ ] Credit Card [ ]
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Credit Card Type
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Visa [
] MasterCard [ ] AmEx [
] Discover [ ]
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Card Number
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Expiration
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Signature
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