Vaccine Order Form

DOWNLOAD PDF VACCINE ORDER FORM

or complete the online form below.

* Indicates required field

Please Select Desired Vaccine *

Viral EHD & BTV Viral EHD Cervid Bacterin ONLY

Number of Doses *

Minimum purchase – 1 bottle = 50 doses

Member's Name *

First

Last

Business/Ranch Name *

Member # *

Phone Number *

Email *

Fax Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Vet Clinic *

Vet's Name *

Veterinarian Clinic Address *

Line 1

Line 2

City

State

Zip Code

Country

Vet's Email *

Vet's Phone Number *

Ship To Address *

Line 1

Line 2

City

State

Zip Code

Country

Responsible for Payment *

Member Veterinarian

Type your name below for your digital signature *

Date *

*The approval process can take up to 3 weeks.

Payment Method *

Credit Card - I will call the DBC with my credit card info within 48 hours after submitting this form. Check - I will send my check within 48 hours to the mailing address below. (Vaccine will not be shipped until the office receives this check)

Please make all Checks Payable to:

The Deer Breeders Corporation
PO Box 688
Millsap, TX 76066
(972) 289-3100

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