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Sex: *  
Is this a new problem?
If NO, is this a re-check?
If prescribed, have you finished all antibiotics?  
What symptoms are present?:         
Appetite:  
What time did you obtain this sample?   
Did you have it refrigerated?

I CERTIFY THAT I HAVE READ AND UNDERSTAND THE ABOVE INFORMATION AND GIVE MY PERMISSION TO THE SAVANNAH ANIMAL HOSPITAL STAFF TO PERFORM THE SERVICES THAT I HAVE REQUESTED. I FURTHER UNDERSTAND THAT FULL PAYMENT FOR THE ABOVE SERVICES WILL BE REQUIRED AT TIME OF DROP-OFF.