Product Order Form Name of the Company*Approved by (Name of the person)*Contact Phone Number*Email Address* Name of Product*Date Requested* MM slash DD slash YYYY Expected Launch Date* MM slash DD slash YYYY Description of the Product*Product Type*100% NaturalNaturalSemi-NaturalSyntheticOtherPlease Specify*Product Functions (purpose and proposed product action)*Product is:*TopicalOralIngestibleInjectablePalatableotherPlease Specify*Product is a:*CreamOintmentOilMistSpraySerumGelLiquidLotionPowderOtherPlease Specify*Is it a Health Canada / FDA licensed product?* Yes No License number*Is Formulation Sheet ready for product?* Yes No Please note changes in formula or reformulation work if needed will cost you extra and notified to you. $250.00 will be charged extra if you need samples of products (2 samples) of your formulation before resuming the productionUpload Formulation SheetMax. file size: 1 GB. Do you have any choice of product properties (color, smell, viscosity, pH, non-greasy etc?)* Yes No Please specify*Do you want us to test the product for micro and heavy metals or other* Yes No Do you want us to package and label product?* Yes No Order quantity*500 Units1000 UnitsOtherPlease Specify*Qty / unit**mlmggfl.ozOtherPlease specify unit of measurement*
