Local: 717 2026

The document is a comprehensive credit application form for veterinary practices seeking to establish an account with Penn Veterinary Supply, Inc. It includes sections for account information, fax permission, online ordering access, and agreements regarding payment terms and compliance with regulations. Additionally, it outlines requirements for obtaining a Florida Health Care Clinic Establishment (HCCE) permit for purchasing prescription drugs and includes a DEA compliance form to ensure adherence to federal regulations on controlled substances. The document also features a customer profile section to gather detailed information about the veterinary practice's operations and preferences.

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Click ‘Get Form’ to open the Local: 717 document in the editor.
Begin by filling out the 'ACCOUNT INFORMATION' section. Enter your practice name, veterinarian’s name, and both mailing and shipping addresses. Ensure all fields are completed accurately.
In the 'FAX PERMISSION' section, provide your signature to authorize fax communications. This is essential for receiving important updates and information.
For 'ONLINE ORDERING ACCESS', create a username and password using alphanumeric characters only. Fill in your email address for order confirmations and promotional emails.
Review the 'AGREEMENT' section carefully. By signing, you confirm that all information is accurate and agree to the terms outlined.
Finally, ensure you include any required documents such as a copy of your valid state veterinary license before submitting the form.

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Versions	Form popularity	Fillable & printable
2021	4.9 Satisfied (32 Votes)
2018	4.3 Satisfied (175 Votes)

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