Dear Wholesaler, I hereby authorise you as my nominated wholesaler to disclose sales related information and data as requested to UVG. This will continue until I notify you in writing to stop. Validate Email Name Date UVG Account Number Phone Clinic Name Clinic Address Clinic Email Address Nominated Wholesaler Provet Customer Number Lyppard Customer Number CH2 Customer Number Cenvet Customer Number Agreement * I am happy for UVG to access my sales data from my chosen wholesaler to assist with estimating my likely annual financial returns through UVG Membership. Terms * I accept the terms and conditions
