We'd like to hear about your experience
with joint disease
and Adequan® i.m. (POLYSULFATED GLYCOSAMINOGLYCAN)
Please help us by submitting your experience.
We will send you
a FREE Adequan®
T-Shirt.
Small
Medium
Large
X-Large
What is your T-shirt size? (check)
Name:
Title:
Business Name:
Address:
City:
State:
Zip:
Phone:
Email Address:
Please send me a DVD of this educational program
Number of copies
I use Adequan® because:
What discipline(s) are you primarily involved with? (check all that apply)
Pleasure
Racing
English
Western
Show/Competition
Dressage
Breeding
I'd like to share my experience with Adequan®:
I give permission for Luitpold Animal Health/Adequan® to use my statements as I submitted on "Experiences With Adequan" web site for use in promotional materials.
If you are a veterinarian
Please have my Luitpold Sales representative contact me.
Please send me the educational brochure
Number of copies
Please send me technical tear-off pads
(50 sheets/pad)
Number of copies
Please send me announcement postcards
Number of copies
How many horses do you treat per year?
0-500
501-1000
1001-1500
1501+
How many cases of DJD do you treat per year?
1-100
101-200
201-500
501+
If you are a horse owner
How many horses do you own?
1-5
6-10
11-25
26-50
50+
None
How many of your horses have suffered from degenerative joint disease?
None
1
2-10
11-15
16-25
26+
Would you use educational information to better understand joint injuries?
Yes
No
If yes, what formats work best?
meeting
printed brochure
video presentation
on-line/web-based educational presentation
Other (please explain below)
See Luitpold Privacy Policy at www.luitpold.com
Click the submit button to save your updated information and receive a
free canvas cap from Adequan®. Thank you for your interest.