Mail Order Form
(FREE SHIPPING)
**IMPORTANT** We MUST see your animal before we can
send out any medication! Refills of other medications may be
available by mail. Call with any questions you may have.

Name: _____________________________________________

Date: ______________________________________________

Phone: ____________________________________________

Shipping Address: ____________________________________

___________________________________

Pet(s) Name(s): ______________________________________

HEARTGARD PLUS (6-pack) QUANTITY

BLUE (under 25 lbs) $32.00 __________

GREEN (25-50 lbs) $42.00 __________

BROWN (51-100 lbs) $48.00 __________

FRONTLINE PLUS (3-pack)

SMALL DOG (under 22 lbs) $47.00 __________

MEDIUM DOG (23-44 lbs) $48.00 __________

LARGE DOG (45-88 lbs) $52.00 __________

EX LARGE DOG (89-132 lbs) $53.00 __________

CAT $46.00 __________

REVOLUTION (CATS)

<5 lbs 3-pack $53.00 __________

5.1-15 lbs 3-pack $57.00 __________ 6-pack $99.00 __________

>15 lbs 3-pack $64.00 __________ 6-pack $104.00 _________

COMFORTIS (flea pill for dogs only)

5-10 lbs 3-pack $55.00 __________ 6-pack $95.00 __________

10.1-20 lbs 3-pack $57.00 __________ 6-pack $97.00 __________

20.1-40 lbs 3-pack $59.00 __________ 6-pack $99.00 __________

40.1-60 lbs 3-pack $61.00 __________ 6-pack $101.00 _________

60.1-120 lbs 3-pack $64.00 __________ 6-pack $104.00_________

CIRCLE METHOD OF PAYMENT (Do NOT send cash)

CHECK (include DL# on check) MONEY ORDER (enclosed)

VISA MASTERCARD DISCOVER

CARD #: ___________________________________ EXP: _____________

SECURITY CODE (Last 3 digits on reverse side of card): ________________

CARD BILLING ZIP: _____________

SIGNATURE: _________________________________________________

**WE DO NOT AUTHORIZE ANY INTERNET PHARMACY Rx**

MAIL TO: P.O. Box 356

North Zulch, TX 77872

OR CALL: (713) 492-8045

(936) 399-6017