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Fax 703-360-1310 www. forthuntanimalhospital.com FULLNAME ADDRESS1 ADDRESS2 CITY STATE POSTALCODE PHONENUMBER CURRENTDATE SHORT Dental Surgical Release Form NAME SPECIES / BREED / COLOR BIRTHDATE SHORT SEX Date of last weight CURRENTWEIGHTUNITDATE SHORT I request and authorize Fort Hunt Animal Hospital to hospitalize my pet for a dental cleaning procedure. After this is completed we will call and provide a treatment plan and estimate for any recommended treatments or extractions beyond...
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