Order Forms - Animal Health Direct

Fade Away Scanning Season Planner Order Form

Direct / Scanner order form

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Blue 220ml $10.65ea (box of 12)

Quantity and Months required

Blue 400ml $13.60ea (box of 12)

Quantity and Months required

Blue 5L Liquid $110.00ea (box of 3)

Quantity and Months required

Pink 220ml

Quantity and Months required

Pink 400ml

Quantity and Months required

Pink 5L Liquid

Quantity and Months required

Orange 220ml

Quantity and Months required

Orange 400ml

Quantity and Months required

Orange 5L Liquid

Quantity and Months required

Yellow 220ml

Quantity and Months required

Yellow 400ml

Quantity and Months required

Notes

Please write any special requirements

Green 220ml

Quantity and Months required

Green 400ml

Quantity and Months required

Notes

Please write any special requirements

Moxisure Cydectin Early Bird Order Form

Direct order form

Station Name(Required)

Station or account name

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Click and collect

Collect from AHD 2 Tumu Way, Longlands, Hastings

Moxisure LA 500ml

Month Required

Cydectin LA 500ml

Month Required

Combination Sheep Oral 20L

Month Required

Active+ Treble 20L

Month Required

Ultramin / Time Capsule Order Form

Direct order form

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Ultra Min

5 Litre

20 Litre

60 Litre

Time Capsule Lamb

48 Pack

36 Pack

Applicator