Allocation Change Request Form

For any questions or issues with completing this form, please contact us by email at info@cpdn.ca

Client Information

* Indicates required fields

CPDN Account Number *

CPDN Account Name *

Contact Name *

Phone # *

Email Address *

Product Information

Select Manufacturer *

The selected manufacturer will receive your request via email.

Any allocation increase request submitted may not be guaranteed to be implemented due to supply and market conditions at the time of the request. The Manufacturer will respond accordingly.

CPDN Product #	Product Description	Current Allocation Qty (units)	Additional Requested Qty (units)	One-time increase	Monthly increase	Add Another Product

View your product allocations in the CPDN WebOMS by clicking 'Current Allocations' on the Home page.

Reason for Request *

Please review all form fields to ensure accuracy before submitting.