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hospital@animalemergencyhospital.ca
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Animal Emergency Hospital Transfer Form
Date *
Reason for transfer*
Transferring clinic*
Transferring veterinarian*
Client name*
Contact number*
Alternate contact number
Estimated time of arrival*
File has been sent by*
Select one
Fax
With client
Email
Patient name*
Breed
Date of birth
Sex
Select one
Male
Female
History/Presenting problem/Physical exam*
