Online Wormer Request Form

  

Your Name
Your Email Address
Daytime Telephone Number
Which wormer do you wish to purchase?
Are the wormers for your own use or resale?
What species of animal is it for?
How many animals are going to be treated?
Are any of them pregnant or lactating?
Age of animals?
Have you used this product before?
Have there ever been any adverse reactions to this product?
If you have answered Yes, please provide details in the box
When were the animals last wormed?
With which product?

 
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                                                                                                                                                                                                     S.P.R. Centre

     Greenfields Farm,  Fontwell Avenue,  Eastergate,  Chichester,  West Sussex.   PO20 3RU        

Tel: 01243 542815            Fax: 01243 544662