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BIOLOGY REFERRAL CLINIC/OWNER INFO: CLINIC NAME: ANIMAL NAME: POSTMORTEM EXAMINATION OWNER NAME: CREMATION/BODY DISPOSAL RELEASE OWNER PHONE: I certify that I am the owner or authorized agent of the owner of the above named animal. I release the above named animal to the University of Tennessee s Veterinary Teaching Hospital: (Please complete all boxes below, sign and date appropriate at the bottom of the form) Perform a Postmortem Examination: Yes (Clinician must complete Necropsy Request.

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