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Please indicate the type of Catalog you would like: ( Medical, Veterinary, Chiropractic)

Catalog Type:

Your Title (DVM, Mr., Mrs.):

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Facility Name:

Address1:

Address2:

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email Address:

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Type of Practice and Percentage of each

Small%

Mixed%

Equine%

Exotic%

Other%

Type of Facility (Small/Medium/Large):

Type of X-Ray (Stationary/Portable):

Manufacturer of X-Ray:

Model:

Last Calibration Date:

Film Processing (Automatic/Manual):

Manufacturer:

Model:

Devleoper Temp:

Grid:

FFD":

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Size:

Cassette/Screen Type:

Chemical Manufacturer:

Chemical Type:

EPA Silver Collector (yes/no):

Type of Collector:

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We will send you information on the following items if you place a X in the boxes that you're interested in.

Accessories:

Film:

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Stationary X-Ray Systems:

Chemical:

Processors:

X-Ray Portables (new/used):

Silver Collectors (methods):

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