Pethealth Sevices (USA) Inc.
P.O. Box 2150
Buffalo NY 14240-2150

1-866-600-4815
Fax: 1-866-440-8479

Pethealth Services Inc
710 Dorval Drive Suite 700
Oakville On L6k3V7

1-866-600-4815
Fax: 1-866-440-8479



24PetWatch Order Form

Customer Number:


Pet Point ID:


Destination:

 
Date(mm/dd/yyyy):


Shelter:


Shipping Address:


City:

 
Prov/State :

 
Zip/PostalCode:

Shipping Contact:


Phone Number:

Email Address:



Billing Address (if different from above):


City:
Prov/State:

Zip/Postal Code:

Billing Contact:

Phone Number:

 


Order Information:


Current microchip inventory count:

Previous microchip:


Type of microchip ordering:

Microchip order amount:

 
 
Do you want to be set up on auto ship ?

If YES:

Auto Order Start Date(MM/dd/yyyy) :

 
Is your organization state tax exempt?
Is your State Tax exemption form on the file already?




Payment Method:

Name of contact we can call to get payment for your first order:

Phone number to reach you:

 

Please invoice us (This option can only be used after your first order)

Contact Name: