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2007 Heartworm Incidence Survey

*Note All fields are required

Contact Information

Email
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Facility Name
Contact Name
Address
City
State
Zip
County

Survey

1. Number of dogs tested for heartworm
(1/1/-7 - 12/31/07)
2. Number of heartworm-positive dogs diagnosed
(1/1/-7 - 12/31/07)

Id Number

Please enter the unique survey number found on your mailed postcard. If you have no ID, please enter "00000"

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Fort Dodge

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