ALLERGIC TO: (Wrap-around) (1) ALLERGIC TO: / ALLERGY (Wrap-around) (1) ALLERGIC TO: CODEINE/SULFA/PENICILLIN (1) ALLERGIC TO: PENICILLIN/CODEINE/SULFA (1) ALLERGIES (1) ALLERGIES []LATEX [] DYE [] TAPE [] OTHER.... (1) ALLERGIES/DRUG REACTIONS (1) ALLERGIES/DRUG REACTIONS NO KNOWN ALLERGIES (1) ALLERGY / ALLERGIC TO: (1) ALLERGY ALERT (1) ALLERIC TO: (Wrap-around) (1) ALLERIC: _____ (1) ANNUAL VISIT NAME__ DATE__..... (1) ANTIBIOTIC___MG (1) APPROACH SLOWLY - Label is Removable (1) ATTENTION OFFICE STAFF: CO-PAY $__ COLLECT AT TIME OF VISIT (1) AUTHORIZATION TO PERFORM EUTHANASIA I AM THE OWNER, OR AUTHORIZED AGENT OF THE OWNER, OF THE ANIMAL DESCRIBED HEREON… (1) AUTHORIZATON TO PERFORM EUTHANASIA DATE____ AS OWNER, OR DULY AUTHORIZED AGENT OF THE OWNER, OF THE ANIMAL… (1) BATH - Label is Removable (1) BOARD - Label is Removable (1) BUTORPHANOL___MG (1) CANINE DENTAL RECORD FOR___... (1) CAT CARRIER PATIENT:___ - Label is Removable (1) CATHETER IN PLACE DATE__ TIME__ TYPE__ SIZE__ - Label is Removable (1) CAUTION - Label is Removable (1) CAUTION: YOUR ACCOUNT IS NOW 90 DAYS PAST DUE. PAY NOW AND AVOID COLLECTION ACTION. (1) CAUTION: DOGS MUST BE BLOOD TESTED EVERY YEAR BEFORE USING THIS MEDICINE. SEVERE REACTION CAN OCCUR IF DOG HAS… (1) CAUTION: FAILURE TO USE AND REFILL THIS MEDICATION MAY LEAD TO FATAL HEARTWORM DISEASE. (1) CAUTION: MAY CAUSE DROWSINESS (1) CHEMOTHERAPY SPECIAL DISPOSAL URINE/BM (1) CONTINUE THIS MEDICATION YEAR ROUND AND REFILL AS NECESSARY. ANNUAL HEARTWORM TESTING IS RECOMMENDED. (1) DATE REC'D___ DATE OPENED__ EXP. DATE__ - Label is Removable (1) DATE____ OPENED - Label is Removable (1) DENTAL NAME___ DATE___ KEY: O = DISPLACED TOOTH X = MISSING TOOTH….. (1) DO NOT EXERCISE (1) DO NOT FEED - Label is Removable (1) DO NOT FEED OR WATER - Label is Removable (1) EXTERNAL USE ONLY (1) F.I.V. + - DATE___ - Label is Removable (1) FECAL RESULT:__ DATE:__ (1) FECAL + - ___ (1) FEEDING [ ]DRY FOOD ONLY [ ]CAN FOOD ONLY [ ]OWN FOOD - Label is Removable (1) FELINE DENTAL RECORD FOR___ (1) FELV + - DATE___ - Label is Removable (1) FINAL NOTICE *THIS IS THE LAST STATEMENT THAT WILL BE SENT TO YOU. *REMIT PAYMENT IN FULL TODAY! *WE ACCEPT VISA & M (1) FINAL NOTICE IF WE DO NOT RECEIVE YOUR PAYMENT BY ___ WE WILL BE FORCED TO TURN YOUR ACCOUNT OVER FOR COLLECTION. (1) FINAL NOTICE IF WE DO NOT HEAR FROM YOU WITHIN 10 DAYS, THIS ACCOUNT WILL BE TURNED OVER TO OUR COLLECTION AGENCY. (1) FINAL NOTICE! (1) FOR EUTHANASIA - Label is Removable (1) FOR REFILLS PLEASE PHONE AHEAD (1) FOR THE EAR (1) FOR THE EYE (1) FOR VETERINARY USE ONLY KEEP OUT OF CHILDREN'S REACH (1) FOR YOUR CONVENIENCE, YOU MAY TRANSFER THIS BALANCE TO YOUR CREDIT CARD ACCOUNT. TO PAY WITH YOUR CREDIT CARD, PLEASE C (1) FRIENDLY REMINDER THIS ACCOUNT IS PAST DUE. YOUR PROMPT ATTENTION IS COURTEOUSLY REQUESTED. (1) GIVE UNTIL GONE (1) GIVE WITH FOOD (1) GROOM - Label is Removable (1) HEARTWORM + - DATE___ (1) HEPARIN FLUSH (1) HEPARINIZED SALINE (1) IF YOU ARE UNABLE TO PAY IN FULL PLEASE SEND A PARTIAL PAYMENT (1) JUST A FRIENDLY REMINDER THAT YOUR ACCOUNT IS OVERDUE. WON'T YOU PLEASE MAIL YOUR REMITTANCE? (1) KEEP IN REFRIGERATOR (1) KEEP OUT OF CHILDREN'S REACH (1) KETAMINE MG/CC (1) KETAMINE___MG VALIUM___MG (1) LAB WORK PENDING - Label is Removable (1) MEDICAL ALERT (1) MEDICATION ADDED TO I.V. PTS. NAME__ ADDED BY__ RETURN TO PHARMACY ON OR BEFORE__ (1) MEDICATION ADDED TO I.V. TIME__ DATE__ BY__... (1) MEDICATION ALLERGY (1) MIGHT BITE - Label is Removable (1) MORPHINE MG/ML (1) MUZZLE - Label is Removable (1) NEW INSURANCE COVERAGE? NOTIFY US IMMEDIATELY IF YOUR INSURANCE HAS CHANGED. SEND US THE ID AND GROUP #'S, PHONE NUMBE (1) NO KNOWN ALLERGIES (1) NORMAL SALINE (1) OK TO FEED AND WATER - Label is Removable (1) ON MEDICATION - Label is Removable (1) OPTHALMOLOGY CHART (1) OWN FOOD ____ - Label is Removable (1) PANEL:ALB__ ALK__ ALT__ AMYL__ CA__ CHOL__ CREA__ GLU__ PHOS__ TBIL__ TP__ BUN__ GLOB__ (1) PAPER LITTER ONLY - Label is Removable (1) PAST DUE *YOUR INSURANCE HAS PAID ITS SHARE. *DON'T JEPORIDIZE YOUR CREDIT. *PLEASE REMIT TODAY! (1) PAST DUE PLEASE REMIT TODAY! (1) PAST DUE PLEASE CONTACT US AT ONCE REGARDING YOUR OVERDUE ACCOUNT (1) PAST DUE PROMPT PAYMENT OF THIS BALANCE DUE WILL PRESERVE YOUR GOOD CREDIT RATING. MAIL YOUR CHECK TODAY. (1) PAST DUE WE ACCEPT VISA AND MASTERCARD. CALL OUR OFFICE WITH YOUR CARD NUMBER. (1) PATIENT RESPONSIBILITY DUE TO: *DEDUCTIBLE *NONCOVERED SERVICES *TOO MANY SERVICES IN TIME PERIOD *MAXIUMUM BENEFIT ALLO (1) PET CARRIER PATIENT___ - Label is Removable (1) PHYSICAL EXAM CHECKLIST 1. BEHAVIORAL [ ] NORMAL [ ]ABNORMAL 2.INTEGUMENTARY [ ]NORMAL [ ] ABNORMAL 3. MUSCULOSKELETAL� (1) PHYSICAL EXAMINATION NAME:__ OWNER:__ DIET:__ VACCINATIONS:__ FECAL:__ HEARTWORM CHECK:__.... - Label is Removable (1) PHYSICAL EXAMINATON 1) GENERAL APPEARANCE [ ]NORMAL [ ]ABNORMAL (1) PICTURE OF CANINE FRONT & BACK (1) PICTURE OF FELINE FRONT & BACK (1) PLEASE CONTACT OUR OFFICE REGARDING YOUR OVERDUE BALANCE. WE'D LIKE TO WORK WITH YOU TO DEVELOP A REASONABLE PAYMENT P (1) PRE SURGICAL LAB. WORK - Label is Removable (1) PROPOFOL MG/CC (1) RABIES MFG__ SERIAL #__ TAG #__ (1) REFILL WHEN EMPTY (1) REFRIGERATE AND SHAKE WELL BEFORE USING (1) REFUSAL OF OPTIONAL TREATMENT(S) OR MEDICAL TEST(S) DATE__ I (PRINT NAME)____ DO HERBY REFUSE THE FOLLOWING… (1) REGULAR MONTHLY PAYMENTS ARE NECESSARY TO KEEP THIS ACCOUNT CURRENT (1) REPORT FOOD/WATER INTAKE - Label is Removable (1) SAVE ALL URINE - Label is Removable (1) SAVE STOOL - Label is Removable (1) SELF PAY (1) SEZIURE WATCH - Label is Removable (1) SHAKE WELL BEFORE USING (1) SITE OF VACCINATION (IMAGE OF CANINE) GIVEN BY:___DVM/CVT (1) SITE OF VACCINATION (IMAGE OF FELINE) GIVEN BY:___DVM/CVT (1) SPECIAL DIET - Label is Removable (1) SURGERY DO NOT FEED OR WATER TODAY - Label is Removable (1) SURGERY IN A.M. REMOVE FOOD 8:00 P.M. - Label is Removable (1) SURGERY TODAY - Label is Removable (1) SURGICAL AND HOSPITALIZATION AUTHORIZATION I HERBY CONSENT AND AUTHORIZE___ TO RECEIVE, PRESCRIBE FOR, TREAT… (1) THIS BALANCE IS OVERDUE! PROMPT PAYMENT WILL AVOID COLLECTION PROCEDURES. (1) THIS BALANCE MAY BE TRANSFERRED TO YOUR VISA OR MASTERCARD JUST CALL US (1) THIS PRESCRIPTION CANNOT BE REFILLED WITHOUT AN EXAM. (1) THIS PRESCRIPTION CANNOT BE REFILLED WITHOUT BLOODWORK. (1) TO GO HOME - Label is Removable (1) UNDER MEDICATION - Label is Removable (1) URINALYSIS NAME:__ DATE:__ APPEARANCE:__ BLOOD:__ COLOR:__ BILIRUBIN:__ PROTEIN:__ KETONES:__SPEC GRAV:__ GLUCOSE:__ S (1) URINALYSIS NAME___ DATE___ METHOD OF COLLECTION___ MIDSTREAM CATCH__COLOR__ GLUCOSE___KETONES__ PH___... (1) URINALYSIS BREED__ AGE__ SEX__ METHOD OF COLLECTION__ TRANSPARENCY__ SEDIMENT__ SP.GR.__ RBC___..... (1) VACCINATE - Label is Removable (1) WE HATE TO KEEP HOUNDING YOU, BUT YOUR BILL IS PAST DUE. (1) WE HAVE NOT BEEN PAID ON THIS CLAIM BECAUSE YOUR INSURANCE COMPANY: *SENT PAYMENT TO YOU *APPLIED THESE CHARGES TO YOUR (1) WE RECOMMEND YEAR-ROUND TREATMENT FOR EFFECTIVE FLEA CONTROL IN THIS CLIMATE. (1) WILL BITE - Label is Removable (1) X-RAY NAME:__ NO.__ DATE:__ TAKEN BY:__ KV:__ EXP:__ COMMENTS:__ (1) YOUR ACCOUNT IS PAST DUE. WE WOULD APPRECIATE YOUR PAYMENT TODAY! (1) YOUR BALANCE DUE TO: *YOUR DEDUCTIBLE *NON-COVERED SERVICES *CO-PAY $___ (1) YOUR INSURANCE COMPANY HAS ALREADY PAID ITS SHARE OF YOUR BILL. THIS STATEMENT IS FOR THE AMOUNT YOU OWE. (1) YOUR INSURANCE COMPANY HAS PAID ITS SHARE OF YOUR BILL. THIS STATEMENT IS FOR THE AMOUNT PAYABLE DIRECTLY BY YOU. PLEA (1) ***Will be DISCONTINUED once stock is depleted*** (5)

FLUORESCENT PINK (6) FLUORESCENT RED (7) FLUORESCENT YELLOW (8) LIGHT BLUE (5) RED (2) WHITE (6) WHITE & BLUE (1) WHITE & RED (2) WHITE WITH BLUE PRINT (2)

1-5/8"H x 3/8"W (1) 1-5/8"W x 3/8"H (1) 1-5/8"W x 7/8"H (7) 1-7/8"W x 3/4"H (1) 2"W x 2"H (1) 2"W x 3"H (1) 2-1/2"W x 2-1/2"H (5) 2-1/4"W x 7/8"H (6) 3"W x 1"H (2) 3"W x 1-1/8"H (1) 3"W x 2"H (1) 3"W x 7/8"H (1) 3/4" DIAMETER (1) 3-1/4"W x 1-3/4"H (3) 4"W x 2-1/2"H (1) 4"W x 2-5/8"H (4) 4-3/4"W x 1-7/8"H (1) 5-1/2"W x 1"H (1)

390/ROLL (4) 420/ROLL (6) 500/ROLL (3) 560/ROLL (6) 570/ROLL (1) 760/ROLL (2)