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Pet Emergency Spokane - Clinic Transfer
1
Is this an Internal Medicine or Oncology request?
Internal Medicine
Oncology
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2
Clinic's name
Doctor's name
Doctor's Phone number
Fax
Email
Client name
Client phone number
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3
Patients name
Patient breed
Age
Sex
k9
feline
k9
feline
k9 or feline
Spayed
Neutered
Spayed
Neutered
Spayed or Neutered
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4
Attach any applicable records
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