Order Products
Richland Creek / PET MED MOBILE
Dr Stan Grist
Online Product Order Form
(Please use one form per pet)
$3.00 shipping and postage applies unless picked up at Richland Creek or at a PetMed Location.
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Heartworm Preventative |
Heartgard Plus
 |
Iverhart
|
Interceptor
 |
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6 months |
6 months |
6 months |
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1-25 LBS.$24 |
6-12 LBS.$18 |
1-10 LBS.$22 |
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26-50 LBS. $32 |
12-25 LBS. $20 |
11-25 LBS. $24 |
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51-100 LBS. $38 |
25-50 LBS. $30 |
26-50 LBS. $32 |
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50-100 LBS. $35 |
51-100 LBS. $42 |
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None |
None |
None |
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Flea And Tick Preventative |
Frontline Plus
 |
1 month
|
3 months
|
|
|
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0-22 LBS. |
$15 |
$42 |
$76 |
|
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23-44 LBS. |
$15 |
$44 |
$80 |
|
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45-88 LBS. |
$18 |
$46 |
$84 |
|
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89-132 LBS. |
$18 |
$52 |
$89 |
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Feline |
$15 |
$42 |
$75 |
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None |
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Heartworm And Flea Preventative |
Revolution
 |
1 month
|
3 months
|
6 months
|
|
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5-10 LBS. |
$15 |
$42 |
$72 |
|
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11-20 LBS. |
$15 |
$42 |
$73 |
|
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21-40 LBS. |
$15 |
$42 |
$75 |
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41-85 LBS. |
$18 |
$48 |
$77 |
|
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86-130 LBS. |
$20 |
$58
|
$110 |
|
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PUPPY/KIT |
|
$35 |
|
|
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Feline |
$15 |
$42 |
$70 |
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None |
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Sentinel
 |
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6 months
|
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2-10 LBS. |
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$55 |
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11-25 LBS. |
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|
$60 |
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26-50 LBS. |
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$65 |
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51-100 LBS. |
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$75 |
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None |
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| TOTAL AMOUNT OF ORDER:
($3.00 shipping and postage applies unless picked up at Richland Creek or at a PetMed Location.) |
| |
Regarding heartworm medications (Heartgard, Tri-Heart, Interceptor, Revolution, Sentinel): If we do not currently have a record on your pet, please advise us of your pet's heartworm test status.
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| Payment Information |
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| NAME:
PHONE:
|
ALT:
|
| ADDRESS:
|
|
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| CITY:
STATE:
ZIP:
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| E-MAIL ADDRESS:
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| PET NAME:
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| DOG
/ CAT
Color:
AGE:
SEX: M
/ F
|
| TYPE OF PET:
neuter:
| spay
| neither
|
|
CHECK |
VISA |
MASTERCARD (Please make checks payable to PET MED MOBILE) |
| CHECK#:
|
| CREDIT CARD#:
| EXP. DATE:
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| CREDIT CARD 3 DIGIT SECURITY CODE: (on back of card):
|
| SIGNED (Print & Fax only): _____________________________________ | DATE: _________________________ |
| |
| You may process your order using one of three methods: |
- Mail - Print this page, sign and date, and mail to us.
- Fax - Print this page, sign and date, and fax to 864-232-2089.
- Submit your order online - Fill in the form above, click this button
|
| Product may be picked up at a PET MED MOBILE location near you. Please call 1-800-228-6007 to schedule your pickup. |
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