Please be sure to enter your Clinic's Zoetis Ship To Account Number, which you can get by filling out this form or by contacting Zoetis Customer Service at 1 (855) 424-7349.

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Account Number: *
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ZIP Code:	*

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Your Clinic Name:	*
Address 1:	*
Address 2:
City:	*
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Zip:	*

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First Name:	*
Last Name:	*
E-Mail Address:	*
Phone:	*

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