med release – The Duchess Fund

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The
medical procedure video we have all been
waiting for is now available for purchase!

This video includes neuters, spays, blood
withdrawal, hoof trim, tusk trim, and
entropion.

All for just $59.95!

Click
Here For More Info!

Donations To The Duchess Fund Are Welcomed

POTBELLIED PIG
MEDICAL RELEASE AUTHORIZATION FORM

I HEREBY AUTHORIZE COPIES OF ANY AND ALL
MEDICAL RECORDS INCLUDING DIAGNOSTIC LAB AND
X-RAY RESULTS TO BE FURNISHED TO THE DUCHESS
FUND™ FOR MEDICAL EDUCATION TO BE PUBLISHED
ANONYMOUSLY.

(A copy of this shall be as
valid as the original)

SIGNED:

X__________________________________________
DATE___________

____________________________________________________________

PRINT NAME

____________________________________________________________

ADDRESS

____________________________________________________________

CITY, STATE, ZIP

____________________________________________________________

PHONE
EMAIL

PLEASE SEND MEDICAL RECORDS TO:

THE
DUCHESS FUND™

408-14TH STREET S.W.

RUSKIN, FL 33570

PH: 813-641-3013

EMAIL:
lordsmom@tampabay.rr.com

FAX: 813-645-1625

THE
DUCHESS FUND IS A CHARITABLE PROJECT TO ENLARGE
THE AMOUNT AND ENHANCE THE QUALITY OF DATA
AVAILABLE TO THE INDIVIDUAL PRACTITIONER RELATIVE
TO THE CARE AND NEEDS OF POTBELLIED PIGS AS LONG
TERM COMPANION ANIMALS.

FOR MORE
INFORMATION GO TO www.duchessfund.org

CALL 813-641-3013 OR 518-747-3494

EMAIL:
lordsmom@tampabay.rr.com

THANK YOU FOR YOUR
SUPPORT!!!!

The
Duchess Fund
408-14th St. S.W., Ruskin, FL
33570 USA

Ph: (813) 641-3013 Fax: (813) 645-1625 E-mail:lordsmom@tampabay.rr.com