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Get LA AEAH Anesthesia & Surgery Form 2017-2022

Rity to perform the following surgical/anesthetic procedure on my pet as described below. Did your pet eat this morning? ( ) Yes ( ) No Current Diet Is your pet currently on any medication(s)? ( ) Yes ( ) No *If Yes, please list the medication(s) and when last dose given: **If fleas or mites are noted on pet upon intake, I understand I will be charged $20.40-$23.49 for treatment (Initials) Estimate I have received and.

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