Vaccine Order Form

Vaccine Order Form

Name: _______________________________ Ranch: __________________________

Type of Vaccine	Price	Bottle Size(s)	Number of Doses
Anaplasmosis*	1 - 49: $7.50 per dose, 50 or more: $6.50	10 Doses 50 Doses
Bluetongue, Strain 10*	$0.32 per dose	100 Doses
Bluetongue, Strain 11*	$0.32 per dose	100 Doses
Bluetongue, Strain 17*	$0.32 per dose	100 Doses
FootVax	$88/50 dose vial $78/vial with order of 12 or more	50 Doses
Vibrio*	$0.38/$0.55 per dose ($47.50/$27.50)	125 Doses 50 Doses

* Shipping charges will apply

Shipping Address (No P.O. Boxes):

Billing Address (if different):

Contact Phone Number:

Note: All orders are shipped by UPS. Anaplasmosis is shipped Ground and should arrive a one to two days after the order is processed. All strains of Bluetongue FootVax and Vibrio vaccines are sent Next Day Air since they need to remain refrigerated. If you have a large order of the bluetongue vaccine, the sterile water/diluent will be sent by UPS Ground and therefore arrive a few days after the vaccine shipment.