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Rizona.edu/vdl/website content/submissionform.pdf AzVDL Use only Client # (1)SPECIMEN RELINQUISHED BY: Date (2) Bill to: (check appropriate box) * Payment is due at time of submission unless prior arrangements are made. Veterinarian: Owner: Clinic: Address: City/State/Zip code: Phone: Fax: E-Mail: Ph Report Y N Fax Y N Email Y N Address: City/State/Zip code: Phone: Fax: E-Mail: (3)**SAVE BODY Y N (4) RABIES SUSPECT*.

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