Telephone: Mobile: Email: 2.2 Use of Products at Site Are the products for administration to animals? Yes No 2.3 Site Types Storage and Handling (picking of goods), Procurement/administration only (no storage) including Distribution Distribution Only Other please specify: 2.4 Categories of Products Handled at this Site Please indicate which categories of products are handled at this site by ticking the relevant tick box; all pharmaceutical forms within specified categories of product are included. Prescription Only Medicines Veterinarian (POM-V) – Prescription Only Medicines Veterinarian, Pharmacist, Suitably Qualified Person (POM-VPS) – Non-Food Animal Veterinarian, Pharmacist, Suitably Qualified Person (NFA-VPS) – Authorised Veterinary Medicines General Sales List (AVM-GSL) – Unauthorised Veterinary Medicinal Products Schedule 6 Products (products marketed under the Exemptions for Small Pet Animals) Veterinary Homeopathic Remedies 2.5 Specific Site Activities Please answer the question below to indicate if the following activity is proposed to be conducted at the site Are Parallel Imported Veterinary Medicinal Products imported at this site?
Telephone: Mobile: Email: 2.2 Use of Products at Site Are the products for administration to animals? Yes No 2.3 Site Types Storage and Handling (picking of goods), including Distribution Procurement/administration only (no storage) Distribution Only Other please specify: 2.4 Categories of Products Handled at this Site Please indicate which categories of products are handled at this site by ticking the relevant tick box; all pharmaceutical forms within specified categories of product are included. Prescription Only Medicines – Veterinarian (POM-V) Prescription Only Medicines – Veterinarian, Pharmacist, Suitably Qualified Person (POM-VPS) Non-Food Animal – Veterinarian, Pharmacist, Suitably Qualified Person (NFA-VPS) Authorised Veterinary Medicines – General Sales List (AVM-GSL) Unauthorised Veterinary Medicinal Products Schedule 6 Products (products marketed under the Exemptions for Small Pet Animals) Veterinary Homeopathic Remedies 2.5 Specific Site Activities Please answer the question below to indicate if the following activity is proposed to be conducted at the site Are Parallel Imported Veterinary Medicinal Products imported at this site?
219404-v23_Application_Form_for_Wholesale_dealer_authorisations.docx