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Clinic Enrollment Form for FetchDx rebates

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What prices do you want us to charge your clients at FetchDx.com for the following kits?
Your clinic will be reimbursed the difference between the sale price and the wholesale price for 1 unit.

The wholesale price for one test is $99.99. The same price is used for both dogs and cats.
No C&S will be run. The wholesale price for 1 unit is $54.99.
The same price is used for both dogs and cats. The wholesale price for 1 unit is $99.99.
Same price for dogs and cats. Intended for routine wellness checks. No C&S will be run. The wholesale price for 1 unit is $79.99.
The same price is used for both dogs and cats. The wholesale price for 1 unit is $54.99.
Each Wee Wand comes with one (1) cup or sponge and a pair of gloves. Recommend this product to pet owners if you want them to bring dog urine samples into your clinic. The wholesale price for 1 unit is $11.99.