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Form for inclusion in the list of vets
If you want your name to be included in the list of vets, please give your particulars in the form below. ALL fields are essential. Submission of incomplete information may result in rejection of application.
Name : Qualifications : Address of clinic : State : Tel No. (Clinic) : Tel No. (Residence) : Mobile No. (if any): Email Address : What kind of animals you treat : Do you treat birds? : No Yes Do you provide 24 hours emergency service? : No Yes Emergency Telephone No. (if any) :
Name :
Qualifications :
Address of clinic :
State :
Tel No. (Clinic) :
Tel No. (Residence) :
Mobile No. (if any):
Email Address :
What kind of animals you treat :
Do you treat birds? : No Yes
Do you provide 24 hours emergency service? : No Yes
Emergency Telephone No. (if any) :
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