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Foster Med Form

Foster Med Form

Forms received by HSSW Clinic Team

This form is intended for current HSSW foster parents to submit medical concerns. Please do not use this form to communicate emergency medical concerns. If you have an emergency, contact the clinic at 360.213.2623 or contact the appropriate staff person for after-hours emergency support.

When completing the form, please provide as much information as possible - this will help our team provide appropriate follow up for you and your foster.

Contact Information

Please enter name and ID for any animal(s) experiencing symptoms.

Diarrhea - Additional Information

Please clarify what treatment or food, how much and how often this is given.

URI - Additional Information

Please note number of days.

Please clarify what treatment or food, how much and how often this is given.

Inappetence - Additional Information

Please note number of days.

Limping - Additional Information

Please note number of days.

Weight Loss - Additional Information

Please clarify what treatment or food, how much and how often this is given.

Other Concern
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