THE SCIENTIFIC RACCOON JOURNAL

A New Dog - Bringing Raccoons in from the Cold in Urban Areas

Register a Raccoon Veterinarian with Veterinarian Short Form One

Veterinarian's Name and Contact Information Business Organization Name:

Last Name: First Name:

Street Number: Street Name: Suite/Unit Number:

City: Canadian Province: Postal Code:

Business Phone: Cell Phone: Email Address:

Name and Address of Appointing Hamlet Ring (Council) and Its Ringmaster (Hamlet Mayor) Hamlet Number (if known): Hamlet Name:

Hamlet Street Number: Hamlet Street Name: Hamlet Suite:

Hamlet City: Hamlet Province: Hamlet Postal Code:

Hamlet Phone Number: Hamlet Email Address:

Hamlet Ringmaster's Last Name: First Name:

Veterinarian's Special Interest and Medical Specialty Veterinarian's Special Interest:..............

Veterinarian's Medical Specialty:..........