Guarantee Application Form

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Please fill in this form ONE TIME ONLY, any omitted information/ document you can ask help from your representative.

With immediate effect, ALL current Mutian users should register the Mutian Guarantee program to the Customer Service Team on or before 7th Apr, 2020. Please submit as much as information you can provide. This form is for Mutian Guarantee Application. We will review the guarantee eligibility for every kitty and contact you 1-2weeks after the deadline if you are eligible to be covered in the Mutian Guarantee Program or not.

For all who have not apply the Guarantee program before the deadline (7thApr2020) will not be covered in the Guarantee program.

New Mutian user after 1st Apr,20 should apply the Mutian Guarantee program within 10 days once you start the treatment.

*** Mutian must be the only brand you used for FIP treatment ***

After filling this form, please attach belows document, specify your name and send to mutianglobalguarantee@gmail.com
1. Send the kitty’s eyes picture and a videos showing your kitty runs & jumps BEFORE the treatment. If you cannot provide it, please state a reason.
2. Send all CBC reports you have before and after the treatment.
3. Provide a weight and Dose adjustment history for your kitty during the treatment.
4. Provide the purchase history or evidence that showing your medication is getting from Mutian online shop or from the representative.
5. Weight and dosage adjustment record during the treatment.

For any enquiries, please contact your Reps or send email to mutianglobalguarantee@gmail.com for further information

All Mutian users MUST follow the guarantee rule during the whole treatment.

If these terms and conditions are met then we can provide free Mutian for your cat. The GUARANTEE begins at day 85 (day112 for Ocular/Neuro FIP) and will be valid for 6 months.
Mutian reserves the rights for final decision.

Please read the guarantee rules before applying the guarantee. Do you agree to follow the Guarantee rule and the instruction? https://www.mutian.com/guarantee *

If these terms and conditions are met then we can provide free Mutian for your cat, until it is fully recovered. The GUARANTEE begins at day 85(day112 for Ocular/Neuro FIP) and will be valid for 6 months.

Yes, I have read guarantee rules and regulations and agree to follow the rules and instruction

No, I don't agree with the guarantee rules and I understand Mutian will not provide guarantee cover on my cat.

Who is your representative?

If you bought from website/ website live chatroom, please state it: website/ chatroom

Your name *

Kitty's name

Type of FIP

Dry

Wet

Other:

Clear selection

Ocular symptom?

For any Ocular symptoms occur before the treatment, please click yes. Any uncertain, please click the "Other" and describe it.

Yes

Other:

Clear selection

Neurological symptom?

For any Neurological symptoms occur before the treatment, please click yes. Any uncertain, please click the "Other" and describe it.

Yes

Other:

Clear selection

Date of birth

DD/MM/YYYY

When was it diagnosed with FIP?

DD/MM/YYYY

Did you use any FIP Treatment other than Mutian ?

If yes, please state the date, period, dosage and the brand.

Treatment start date

The date of the first dose

YYYY

Weight before treatment

please specify the unit of weight

Dosage when treatment start

please specify the relevant unit. For capsule, in mg. For injection, in ml.

Current weight

please specify the unit of weight

Current Dosage

please specify the relevant unit. For capsule, in mg. For injection, in ml.

Gender

Gender of kitty

Male

Female

Other:

Clear selection

Breed

Medical history

Do you have the FeLv and FIV test done? What is the result?

Are you giving rx vitamins?

Please specify the type of Rx Vitamins

Any other supplement you are giving?

If you are not giving Rx vitamin, also state what kind of vitamins you are using here.

Any other medicine you are giving?

How is your kitties appetite now?

How is your kitties energy level?

Your purchase history on Mutian

Purchase date(DD/MM/YY); no. of Capsule/ vials; purchase channel; (e.g. 20/2/20;1box200mg+3vials; online store; 30/2/20; 5caps50mg; from Reps)

Where are you based?

How can we contact you?

leave your email: XXXXX@xxxx.com or facebook name (www.facebook.com/xxxxxxxx) here, or Whatsapp (+X XXXXXXXX)

Anything you would like to ask or you want to mention

After filling this form, please attach Bloodwork,ultraound,Xray, Eye picture, running jumping video, specify your name and send to mutianglobalguarantee@gmail.com *

Your cat will not be eligible for the guarantee program if you do not send the document to the above email.

Yes, I understand.

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