New In-House Product Request Form

NEW IN-HOUSE PRODUCT REQUEST
Full Name*
Email*
example@example.com
Product Name*
Product Description
Provide as many details as you have (size, strength, form, etc.)
How can we help move this product request along?*

Before an order is placed for this product, I'd like some research doneI don't need product research done. I would like the product ordered asap
Research Needs (Select all that apply)*

Product CostAvailabilityAvailable Size(s)Available Strength(s)Expiration WindowVendor NameOther
Other Research Needs
Will this product be charged directly to the client(s)*

Yes, it will be charged directly to client(s). We'll need to set a priceNo, its part of another service. it will NOT be charged directly to client(s)
Please tell us how often you will need this product*

Temporarily/Specific Case. No need to stock permanentlyI would like this product stocked on an ongoing basis
Temporary / Case-Specific Use Explanation *
Keep in stock at these locations (select all that apply):*

PW Highland HeightsPW FlorencePW Home Vet Care Units
HH Stock Level*
Keep this many on-hand
FLO Stock Level*
Keep this many on-hand
HVC Stock Level*
Keep this many on-hand
Will product replace or reduce use of another product?*

No. This product serves a different purpose than any current productYes. This product may replace or reduce sales/usage of a current product
What product(s) might be replaced/reduced? *
Please briefly explain the purpose/use case of this new product*
This item will be directly charged to clients. How would you like to handle pricing-setting for this item?*

I would like to set the client price right nowI would like the Inventory Manager to set the client price
Set the Client Price to:*
Inv to Set Price?

YesNo-Already Set
Pre-Auth?

YesNo
Should be Empty:

NEW IN-HOUSE PRODUCT REQUEST