IDEXX 2010 National Feline Infectious Disease Prevalence Study Enrollment Form As a leading-edge practitioner, you are invited to participate in this study, which will raise standards for feline medicine.   When you participate in the 2010 National Feline Infectious Disease Prevalence Study, you can: •  Identify which of your patients are affected by these diseases •  Help your clients understand the importance of testing for these diseases and improve compliance •  Earn an end-of-study rebate per test submission Enroll by May 15, 2010 and provide the test result information for FIV, FeLV and feline heartworm to IDEXX by September 30, 2010.  In return, IDEXX Laboratories will provide a rebate of $1 per result in the form of IDEXX Points† at the end of the study. The combination of all three results (whether positive or negative) per device qualify as one test submission.     Yes! We would like to participate in this important study. Please send our study materials.*   Please fill in your practice information below.     Contact Name     Practice Name     Address     City     State     Zip     Phone Number     Fax Number     E-mail     Distributor Rep       Distribution company   Butler Schein MWI   Hawaii Mega Corp PVP Midwest Victor IDEXX/Other (specify) Webster Questions?  Call Erin Wood at 207-556-4914 or e-mail erin-wood@idexx.com. Please click "submit" to send in your information. Thank you! *  Allow two weeks after completing your enrollment for delivery of your participation packet for this study. †  This rebate will be applied to your IDEXX Points account at the end of the study. IDEXX Points are dollar equivalent (one point = $1.00) and can be used to purchase IDEXX products and services, including diagnostic equipment and maintenance agreements. To find out the balance of your IDEXX Points, please call 1-800-248-2483.