CVMA Regulatory Compliance Products Order Form

CVMA Guide to Cal/OSHA Compliance — Everything you need to comply with Cal/OSHA requirements. Online subscription only.

Mandatory Pamphlets for Employees

Regulatory Plaques (please specify)

� Abandoned Animal Act (VMB requirement)

� Prop 65 warning for employees (Required for practices with more than 10 employees)

� Continuous Presence Not Provided (VMB requirement)

� Written Prescription Upon Request (VMB requirement)

� Written Prescription Drug Dispensing — Prescription Required (Satisfies requirement for written notification)

� Financial Interest Disclosure Plaque (VMB requirement, if applicable)

Full Name: Phone #:

Hospital Name: Shipping Address (no PO Box #s): City, State, Zip:

Check enclosed made payable to CVMA MasterCard VISA Discover AmEx Card Number: Exp. Date: CVV:

Signature: Date:

Please allow up to five business days for the CVMA Guide to Cal/OSHA Compliance order to be processed. You will then be able to view the guide online by clicking on the CVMA Guide to Cal/OSHA Compliance link at the bottom of the CVMA-InLine website home page after you login. Please allow up to three weeks to receive the New Hire packets and the plaques. All returned items are subject to a 15% restocking fee; shipping charges on returns are the customer’s responsibility. Credits will be issued only for returned item in original condition within 30 days.