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Drug Collection Request

    Everything marked with a star (*) is required

    Your Details

    Name *
    Phone *
    Email *

    Drug Details

    Company / Farm name *
      Drug Amount
    Collect On Example '1st June' or 'Next Monday

    We will contact you within 24 hours to confirm a collection time.

    Your Data

    We take the privacy of your data seriously and will only use the data that we collect on this form to process your appointment request. For full details of how Towcester Veterinary Centre process your personal information please read our Privacy Notice, which you can access from the link at the bottom of every page on our website.