Please fill out the form below to enroll in the VetriScience
®
Vet Staff Program.
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to sign in.
First Name
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Last Name
*
Email Address
*
*
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Job Title
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Veterinarian/Associate
Veterinary Assistant
Veterinary Technician
Practice Manager
Veterinary Student
Distributor
Other
Clinic or Organization Name
*
*
Phone Number
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*
Address
*
Address 2
City
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State
*
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Postal Code
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I am qualified for the program as I am affiliated with a veterinary hospital, distributor, or school.
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I understand that there is a purchase limit of 6 products per month.
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I agree that the products purchased through the program are for personal pet use only and are not for resale.