ࡱ> ]_^q` jbjbjqPqP 86::> +    D4 CHHHHH---CCCCCCC$}DhFj,C <-|-<<,CHHAC???<.tH HC?<C??A AH< P~;<ACWC0CAOG=*OGAOG A-12L?}5!8---,C,C>---C<<<<          Animal Emergency Hospital Animal Emergency Hospital-Volusia Of St Johns County 918 Ridgewood Avenue 2505 Old Moultrie Road Holly Hill, Florida 32117 St. Augustine, Florida 32086 386-252-0206 386-252-0230 FAX 904-794-5072 FAX ____________________________________ ____________________________________ Referring veterinarian Owners name ____________________________________ ____________________________________ Clinic name Address ____________________________________ ____________________________________ Address City State Zip code ____________________________________ ____________________________________ City State Zip code Home # / Cell # ____________________________________ ____________________________________ Phone # / FAX # Work Phone # ____________________________________ Prior Medical History: _________________ Pets Name ____________________________________ ____________________________________ ____________________________________ Birthdate Sex ____________________________________ ____________________________________ ____________________________________ Weight Color ____________________________________ Parasite control summary: _________________ ____________________________________ CHIEF COMPLAINT (WORKING DIAGNOSIS): HISTORY, DIAGNOSTICS, & TREATMENTS (SUMMARY): PLEASE SEND COPIES OF ALL PERTINENT RECORDS, LABORATORY RESULTS, RADIOGRAPHS, ETC. To Animal Emergency Hospital To Animal Emergency Hospital of St Johns County: Volusia:     Directions from Palm Coast and locations north: Take US1 South (becomes Ridgewood Avenue). Clinic is 8.6 miles south of I 95/US1 intersection. Directions from St. Augustine, The Beach, and North of the City: Directions from Port Orange Take US 1 South to Lewis Point Road and locations south: Turn right on Lewis Point Road Take I 95 or Nova Road North. Turn left on Old Moultrie Road Exit LPGA Boulevard East to US 1 (Ridgewood Avenue). Turn Right on US 1 (Ridgewood Avenue). From Flagler County, Palm Coast Clinic is .3 miles south, And South of the City: on the right side of the road. Take I-95 to US 1 N. Take US 1 N. into St Augustine From Deland and Turn left onto Lewis Point Road locations West: Turn left onto Old Moultrie Road Take 92 East to LPGA Boulevard. Turn Left onto LPGA. From Hastings, Palatka, Follow LPGA to And West of the City: US 1 (Ridgewood Avenue). Take 207 into St. Augustine Turn Right onto Turn right onto SR 312 US 1 (Ridgewood Avenue). Turn right onto Old Moultrie Road Clinic is .3 miles South, Hospital is 1.5 miles south on the right side of the road. From Area Beaches: Take Seabreeze Bridge West. Turn Right onto US 1 (Ridgewood Avenue). Clinic is 1.3miles north, on the left side of the road. LPGA BLVD I-95 US 1/ Ridgewood Exit 273 Ormond Beach SR 40 918 Ridgewood Harley Davidson Animal Emergency Hospital Hwy 92/ International Mason Ave I-4 N Old Moultrie Rd 207 Cobblestone Village WALMART U.S. 1 Hess Lewis Point Rd 312 Animal Emergency >RWkl ! B G H c p    - M l q r s øíÏ˭Ï˄Ïˏh,h]RCJaJh,hG=CJaJh35;CJaJh,h2`CJaJh,hECJaJh,hCJaJhIlCJaJh,hIlCJaJhz#hp&heh?phEhVh?p5 h?p5hVhE54?lH p  M " N W  gdk!@gd,gd@gdIlgdz# & FgdEgdE>i  ! 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