Custom Softgel Form
Minimum Order Quantity (MOQ) / R&D Fees for Softgels
MOQ 150,000 Softgels / R&D $1,500
Date
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
JAG Rep Name
*
Please Select
Barbara Hines
Casey File
David Whitmer
Dennis Collard
Ellen/Scott Struber
Heidi Simon
JAG (Unlisted or Unknown)
Kaitlin Schmidt
Lena Akerman
Marzena Jonak
Sherrell Gilmore
Travis Keziah
Billing Information
Company Name
*
Company Website
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Product Information
Target Price (this is the price you are wanting us to formulate to. Not your retail price)
*
Target Launch Date
-
Month
-
Day
Year
Date
Ingredients
Note: If customer is providing Active Ingredients, please provide COA with Lab Testing to match order form selection below. All shipments arriving will also need a packing slip with all containers properly labeled with Lot's #, tare weights, and net weights.
Are any of the ingredients being provided by the client? If yes please list each of the ingredients.
*
Please include all ingredients required AND specify amount of mg of each ingredient per softgel.
*
If this product Contains CBD please list the type of CBD and mg per softgel
*
Ingredients or types of ingredients to avoid when formulating?
*
Is there an existing product that you would like to use as a benchmark?
Back
Next
Packaging Options
Bulk Packaging
*
Yes, skip bottle selection
No, proceed to bottle selection
Back
Next
Bottling Selection
Bottle Type
*
HDPE
PET
Other
Bottle Size
*
60cc
75cc
100cc
120cc
150cc
200cc
250cc
300cc
400cc
Other
Bottle Color
*
White
Black
Clear
Other
Cap Type
*
Smooth
Ribbed
Child Resistant
Other
Cap Liner
*
Pressure
Heat Induction
Other
Tamper Proof/Neck Band
*
Clear/perforated
Other
Label
*
Label
No label
Total Bottles Needed
*
Number of softgels per Bottle
*
Packaging
*
Single Carton POP Box
No Single Carton POP Box
Custom POP Box
Back
Next
Custom POP Box
If you chose Custom POP box please specify details here
*
Back
Next
Master Cases
Master Cases (shipper boxes)
*
Master cases needed
Master cases not needed
Other
Back
Next
Master Cases Information
If master cases are needed please specify details here. Please note information needed on box label: i.e., Lot #, Product #, Product name
*
Back
Next
Softgel Quantities
Total Number of Softgels needed (minimum order is 150,000)
*
Back
Next
Shipping
Shipping Details
*
LTL (palletized)
UPS/FEDEX/USPS
Other
Company Name & Shipping Contact Name
*
Who do we address the shipment to?
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Shipping Contact Phone Number
*
Please enter a valid phone number.
Shipping Contact Email
*
example@example.com
Shipping Hours
*
Lift Gate Needed
*
Yes
No
Back
Next
Lab Testing
Lab Testing Requirements
*
Potency Only
Mycotoxins Only
Microbials Only
Heavy Metals Only
Residual Solvents Only
Pesticides Only
Full Panel (ALL OF THE ABOVE)
Back
Next
Notes
Please provide any additional details you wish to share with our formulation team.
Upload any documents, packaging or POP images
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: