Veterinary Clinic Kits

Please fill out the form below to get set up for your Veterinary Clinic Kit! This includes product samples and educational materials for the cats and cat parents of your practice.

Veterinary Clinic Kit

We are only able to ship kits within the USA

"*" indicates required fields

Clinic Information

Clinic Name*

Primary Clinic Contact*

First Last

Phone*

Email*

Veterinary License*

Please include name of vet and license number if primary contact is clinic support staff. We will verify your license number to ensure these kits are being used for their intended purpose.

Shipping Address*

*No PO Boxes

Street Address Address Line 2 City State ZIP Code

Signature*

The undersigned acknowledges that the Dr. Elsey’s Veterinary Clinic Kits are to be used with the purpose of educating clients about our line of veterinarian formulated products. Kit orders can be placed once every 30 days.

Authorized Clinic Representative Date