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Pet Dowsing Profile

You have successfully accessed the Pet Dowsing Profile page. Please fill it out and submit it. Once I receive the form I will do the evaluation and call you by phone with the test results. 

Note: You need to make a payment before the evaluation is completed. Click on the left side of this page "Personal Pet Dowsing" and follow the instructions to make your payment. 

* Required fields
Name *
E-mail Address *
Today's Date: *
Current Mailing Address: *
Phone:( Land Line ) or Cell Phone *
Fax Number:
Pet's Name:
Type of pet or animal? *
Gender M / F *
Age:
Weight:
Main Complaint's:
Operations or Organs removed during your pet's lifetime
Prescription Medications your pet is currently taking: If so, for what condition?
Supplements or food (Brand Name) you are currently feeding your pet on a daily basis:
Dietary Restrictions or Food Allergies of your pet (if known)
Additional Information I should know before testing your pet ?
Your Electronic signature OR Type in your full name * *
Date of Signing:


 

 

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