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By clicking this box, I do hereby grant permission to release any or all of the information contained in the medical records of my pets listed below to Flowertown Animal Hospital
Species
Canine
Feline
Avian
Reptile
Small mammal
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Sex
Neutered Male
Spayed Female
Intact Male
Intact Female
arrow&v
Species
Canine
Feline
Avian
Reptile
Small mammal
arrow&v
Sex
Neutered Male
Spayed Female
Intact Male
Intact Female
arrow&v
Species
Canine
Feline
Avian
Reptile
Small mammal
arrow&v
Sex
Neutered Male
Spayed Female
Intact Male
Intact Female
arrow&v
Species
Canine
Feline
Avian
Reptile
Small mammal
arrow&v
Sex
Neutered Male
Spayed Female
Intact Male
Intact Female
arrow&v
Species
Canine
Feline
Avian
Reptile
Small mammal
arrow&v
Sex
Neutered Male
Spayed Female
Intact Male
Intact Female
arrow&v
I authorize FAH to photograph my pet and celebrate them via pictures on social media and/or our hospital website (check one)
Yes
No, thank you
Thanks and Welcome to the FAH family!
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