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My location preference for picking up products is ...
My doctor preference is ...
Owner's Name
Co-Owner / Spouse / Secondary
Street Address
City, State, Zip
Mailing Address (if different)
Countryside Animal Clinic utilizes a digital email and text messaging system for vaccines and appointments. WE NO LONGER SEND POST CARD REMINDERS.
I give Countryside Animal Clinic permission to take and use photographs of my pet for any lawful purpose including publishing in print and/or electronically.
Cell Phone (Primary Phone)
Home Phone
Co-Owner / Spouse / Secondary Phone
Email
Photo of your Pet(s)
Does your pet have an Instagram page we can follow? (Follow us @CountrysideAC)
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One fine body…