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Animal Health Clinic of Funks town Authorization for Anesthesia and Dental Care for Canines Client Name: Pet's Name: Species: CanineBreed: Age: Sex: Male Female Neutered Spayed I, the undersigned
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To fill out please initial which treatment, follow these steps: 1. Start by writing your full name at the top of the form. 2. Look for the section that asks for the treatment being requested and initial the appropriate box for the treatment you need. 3. If there are multiple treatments listed, make sure to only initial the box for the specific treatment you are seeking. 4. Double-check your initials to ensure they are clear and legible. 5. Finally, review the form to make sure you have filled out all other required information before submitting it.

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Please initial which treatment is needed by individuals who are seeking a specific medical treatment. This could include patients, clients, or individuals who are undergoing a particular therapy or procedure. It is important for the person who needs the treatment to accurately indicate their choice by initialing the appropriate box on the form.
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