Hawkins, Inc. - Pharmaceutical Group: Refer-A-Friend

Hawkins Pharmaceutical Referral Form

Rules:

1.
Referral must be a valid, compounding pharmacy that does not currently do business with Hawkins Pharmaceutical Group.

2.
Referral form must be entirely filled out.

3.
One 10% coupon will be awarded for each qualified referral (and will be issued upon verification).

4.
Each coupon will expire one month from date of issue.
If you are a new customer, you will receive a 10% coupon by filling out the referral form with your information.

YOUR INFORMATION
Your Name:
Pharmacy Name:
Account Number (if known):
Address:
	,
Phone Number:

REFERRAL INFORMATION
Contact Name:
Pharmacy Name:
Address (if known):
	,
Phone Number: