Please submit this enrollment form prior to first order in order to update your organization’s ordering status with the authorized distributor of your choice.
"*" indicates required fields
- Behavior Management Support
- Critical Care Support
- Nutritional Therapeutics
- Parasite Control
- Surgical Suite and Wound Care Products
Behavior Management Support
Critical Care Support
- Liqui Tinic™ 4x
- Pet-Ema® & Feline Pet-Ema®
- OPTIMA 365™
- Mycodex® Flea & Tick Shampoo P3
- Mycodex® All In One™ Flea & Tick Spray
- Mycodex® Plus Environmental™ Control Aerosol Spray
Surgical Suite & Wound Care Products
- Collasate® Family
- Monomend® ST
- Monomend® MT
- Monomend® MaX
- Ploymend® MT
- PRO-STA® FLX
- NFP Accounts must place orders (“Orders”) through an authorized PRN® Pharmacal distributor.
- Orders must be dated after January 1, 2022 and before December 31, 2022.
- New program participants must be pre‑approved by PRN Pharmacal Regional Sales Representative AND program enrollment form (see reverse side) must be submitted prior to first Order submission.
- May not be combined with any other PRN Pharmacal promotional programs.
- Free goods are only eligible for qualifying products.
- Program participants must re‑enroll each year.