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Planning to improve communication

Posted By Christine Shupe, Monday, June 25, 2018

Effective communication is the foundation of a strong and trusting professional-client relationship. In fact, it may be as important as the quality of care provided by a practice. While a team can be technically gifted, if the client does not feel respected, listened to and informed about their pet’s care, it can result in unhappy clients who are less inclined to comply with the practice’s recommendations. Although effective communication may not be a panacea for all the challenges that the healthcare team and client struggle with, it can position the team for more productive encounters with clients.

Consultants in the area of improving communication in the healthcare setting identify these issues as ones that should be considered when evaluating or developing a practice communication strategy.

Focus on empowering the client: The relationship between healthcare staff and client is one of imbalance---the healthcare team has the medical expertise and the client is the pet parent. Communications that take place in the healthcare setting should always involve give and take. The healthcare team should make every effort to invite the client into the conversation and listen to the insights and information provided.

Manage client expectations: An integral component of communicating effectively is managing expectations. Clients whose pets receive a clean bill of health and an appointment to return in a year should have a clear understanding that they have an impact on their pet’s health and complying with preventive care protocols is the best way to ensure their furry friend remains healthy and happy. Should the client’s compliance become lax, they cannot realistically expect that the pet’s good health is guaranteed.

Make it a point to make the team a font of information: Thanks to the internet, information is everywhere. What you don’t know or didn’t hear correctly can be googled. The healthcare team can minimize confusion if they are clear about what is occurring during the visit, repeating and rephrasing information and giving the client an opportunity to ask clarifying questions. The goal is to set up a protocol for dispensing information so that when the visit is over, the client does not have to search other sources for information.

Because professionals---regardless of their areas of expertise---have a tendency to overestimate their ability to communicate effectively, tools that offer an unbiased representation of the effectiveness of the communication that occurs during the office visit are helpful. The Opportunity---the online survey tool from Partners for Healthy Pets (PHP) is one such tool. The Opportunity tool helps uncover communication disparities between what the healthcare team says and what the client hears. The site also provides scripts, videos and other supporting materials useful when creating your communication plan. 


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Don’t Bite Off More Than You Can Chew!

Posted By Christine Shupe, Wednesday, May 2, 2018

Better to address guidelines one population at a time



When creating preventive healthcare protocols, the prudent advice from experts is, “Don’t bite off more than you can chew!”


Written preventive protocols should be crafted for the different pet populations treated in the practice. There are protocols for felines and canines, as well as the young, middle- aged and seniors. That’s a lot of protocols! Drafting and creating these guidelines can easily become time consuming, unwieldy and complicated by the size of the practice and the number of staff contributing to the process.


VHMA’s Susan Savage, CVT, CVPM. MBA, PHR, who facilitates a group of practice managers who are using the VHMA's Preventive Pet Healthcare: Your Guide to becoming a PRACTICE CHAMPION tool to develop guidelines for their practices, strongly encourages managers to consider how the process will play out when numerous guidelines must be coordinated among a number of staff members.


Susan’s suggestion? Start small! She does acknowledge that when staff is excited about implementing a program or procedure, the energy generated by their enthusiasm can be difficult to reign in. After all, who wants to listen to the skeptic in the room? However, group feedback reveals that practices that take on too much at one time are likely to accomplish less.


 Lesson learned: Don’t be afraid to push back against staff’s desire to do it all. In the long run, you will avoid the frustration that can ensue when staff finds that the process becomes unwieldy and complicated by many moving parts. Start small, enjoy the success and apply what works and avoid what doesn’t work when crafting future guidelines.


Making Choices


When selecting the guidelines to tackle, stick to the road well-traveled. If there are protocols—or something vaguely related to protocols---available in the practice, use those as the starting point. AAHA/AVMA Guidelines should be considered in conjunction with the practice protocols during the review process. For the group’s first foray, consider selecting a population for which generating protocols are straightforward to increase the likelihood of success.


Suggestion: Susan recommends starting with middle-aged canine guidelines as the protocols may be less extensive than those for puppies and seniors.


Coordinating Participation


Not surprisingly, coordinating the protocol process of a small practice is less cumbersome than coordinating the efforts of a large practice simply because there are fewer players involved. Even in a small practice, given workloads and schedules it may be difficult to arrange a time for the entire staff to sit together and brainstorm.


Based on the group’s experiences, members suggest starting the guideline review with the veterinarians. Based on their feedback continue revising and circulating to other select groups. Continue the review as the guidelines evolve.


Regular updates are key. Not only do they communicate to staff that they are an essential part of the process, it ensures that the entire staff is aware of tweaks and revisions and creates a sense of ownership and commitment.


The piece-by-piece strategy to create guidelines can encourage participants to be more thoughtful in their review and evaluation of the materials.


Recommendation: Identify a system for communicating information about the developing guidelines. Whether it is through email, regular meetings or another means, having a predetermined system in place will ensure that contact with participants is ongoing.


Adhering to the Guidelines


Creating the guidelines is not an end in itself. The guidelines should be committed to paper and become an integral part of office procedure. Creating a checklist that is posted throughout the practice can increase guideline compliance among staff.


Practice Tip: Creating guidelines is not a once and done exercise. Continue to refer to the guidelines with staff at meetings. Follow-up with questions to discern how effective the guidelines are. Invite staff to submit suggestions to improve the protocols.



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Moving Forward with Forward Booking

Posted By Christine Shupe, Friday, April 27, 2018
Updated: Friday, April 27, 2018

When aiming to create new policies and procedures, it can be a lengthy and stressful process depending on the issue and how receptive staff is to the new policy. Introducing a forward booking policy is no exception. We know that done right, forward booking can result in healthier patients and a healthier bottom line for the practice. Successful implementation depends on staff transitioning to a new routine. Even the slightest change in “business as usual” can cause discomfort, anxiety and, at time, resistance.


Susan Savage, CVT, CVPM, MBA, PHR, group facilitator for the VHMA Champion Workgroup – FORWARD BOOKING, shared some sage advice from a group of practice managers that are exchanging insights about their experiences with introducing forward booking in the practice. Although each is at different points in the implementation process, their feedback and suggestions are valuable to managers who are either planning to introduce forward booking or are in the midst of the process.


Susan stressed that forward booking should be initiated for all visits---both wellness and medical progress exams. She acknowledged that most practices are already using forward booking to schedule medical progress reviews/rechecks and blood testing. Scheduling these appointments seems to be more intuitive because they represent the next steps in a treatment plan. She and the group did observe that staff members were not booking for wellness visits during progress visits and that they need to be thinking about wellness appointments at every visit.


Forward booking preventive healthcare visits, in general, can be a bit challenging because the visits are booked so far in advance that clients may be reluctant to make a commitment.


The issues, however, are not insurmountable. Summarized below are some of the lessons learned from those on the front lines.


1. Make sure the veterinarians in the practice are committed to and see the value of forward booking. They must understand and support the concept because their input is essential for setting the parameters of the forward booking policy.


2. When a policy has been outlined and forward booking has been incorporated into the practice’s procedures, identify a system for gathering baseline data regarding client compliance with the preventive care protocol. This information will be essential further down the road to assess the success of forward booking and identify areas that need to be improved and changed.


 3. Before presenting forward booking to the team and giving them their marching orders, button up the details. Identify and assign team and individual roles and responsibilities. Implementation should be specific.


4. Decide how to ensure that forward booking is a top priority for staff. Reminders can reinforce the action staff must take and can take many forms…posters, checklists, clever sayings posted on the wall…the possibilities are endless. Be bold, be creative! The goal is to sear forward booking into the memory of staff. Flyers are availed at They can be printed and posted throughout the practice.  Partners for healthy pets will provide Forward Booking buttons for staff members to wear as reminders and a way to get the conversation started with clients.


5. From those who know, an important tip…Many practice management software programs have features that provide a forward booking alert to staff members. Make certain that feature is active.


6. Remember to set up reminders to clients that are sent in advance of the next appointment so the client can change or cancel if needed.


Susan and the group members admitted that it has taken a bit of prodding and reminding to get staff to forward book preventive health visits, but they continue to devise strategies to support staff. To date they have discussed training, reminders, goal setting with staff, and yes, even offering rewards!



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That Space Between Us: What We Say, What Clients Hear

Posted By Christine Shupe, Thursday, February 15, 2018

That Space Between Us: What We Say, What Clients Hear



Partners for Healthy Pets published the results of a study that examined whether clients retain and process what veterinary professionals believe they communicate during preventive healthcare exams. To determine if a disconnect exists, Partners for Healthy Pets employed The Opportunity survey and gathered data over a five year period. Between April 2013 - June 2017, 1,193 staff members and 1,360 pet owners completed surveys. Although more dog owners (833) were surveyed than cat owners (527), pet owners in general are not completely tuned in to what veterinary staff is saying.


Ramifications of poor communication


When clients do not hear what they are being told during the exam, it means they are not fully grasping the significance of what occurs during the office visit and are probably not understanding the importance of the services provided. This lack of attention can impact their attitudes towards veterinary care and negatively effect a pet’s health. When staff communicates clearly and directly, clients are more likely to leave the office feeling relieved that the pain assessment did not reveal any significant issues, as opposed to walking away lacking information and wondering whether the investment of time and money in the visit was worth it.


Identifying the gaps


The Opportunity survey measures communication issues in two areas: gaps related to services performed during an exam and gaps related to the importance of the services performed.


Data related to client awareness of services performed was collected for canine owners and feline owners.

These responses were compared to staff responses about services discussed during the exam. 


According to staff, during a canine preventive healthcare exam, the services that are commonly performed are: dental exams (95%), weight and nutritional assessments (89.5%) and pain assessments (73%). When pet owners were asked if the above-referenced services were discussed during the exam, 77% recalled the dental exam, 77% remembered the weight and nutritional assessment and only 45% had any memory of a pain assessment. These results signal a fairly significant disconnect between what staff report they do and what clients are able to call to mind.


Feline exam results were similar. Ninety-five percent of staff indicated that a dental exam was performed and 78% of clients reported that the exam occurred. Pain assessments were conducted by 68% of staff, yet only 30% of clients said that the assessment was discussed during the visit.

The gap between broad-spectrum parasite control (55% of practices discuss, 44% of clients recall) and internal parasite tests (performed by 54% of practices and remembered by 43% of clients), was not as wide but still significant.


You don’t appreciate me


Underappreciating services can have a bearing on whether clients will use a service and this was illustrated in The Opportunity results.


Staff members characterized the following canine services as important: pain assessment (94%), heartworm test (93%) and behavioral assessment (90%). Clients had a different view of the importance of these services: 80% rated pain assessment as important, 80% said the heartworm test is important and 71% indicated a behavioral assessment is important.


Closing the gap in your practice


The first step in closing the communication gap is to identify specific services that are typically addressed in a preventive healthcare exam and receive feedback from both staff and clients. The Opportunity tool is a great start. It can be downloaded from the Partners for Healthy Pets’ website and is easily administered.


The survey lists 10 services---11 for feline visits---and participants are invited to comment on whether these services were provided or discussed during an office visit. The difference in results can be used to identify the gaps in understanding, or areas in which the practice needs to direct its attention to educate clients. The number of areas that require further attention can range from none to 10.


Once gaps are identified, the Partners for Healthy Pets website contains communication modules with scripts and videos that practices can use to explain the importance of preventive care to their clients. Research shows that even a few words that draw the client in and clarify the purpose of the visit can help them understand how essential preventive care is to their pet.


For more information - check out the Partners for Healthy Pets Opportunity Tool.




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Make Preventive Care a Priority

Posted By Christine Shupe, Monday, January 29, 2018

Even the most assertive clients can be passive…passive about their pets’ healthcare!


Such clients --- and there are many --- contact the practice only when their pets exhibit noticeable symptoms. When clients are unaware that proactive actions and preventive care can have a positive impact on their pets’ longevity and general health, the client and patient suffer. Veterinary professionals must reverse this trend by promoting health by advocating for prevention to achieve better outcomes.


Successfully pitching preventive care to clients is not easy. Guidance and strategy can be an enormous help to veterinary staff. Templates and programs are available to guide professionals through the process. For example, Partners for Healthy Pets offers a Preventive Healthcare Certificate Program that focuses on the tools and resources to communicate the importance of preventive care to clients. Moreover, The VHMA’s Preventive Pet Healthcare, Your guide to becoming a PRACTICE CHAMPION, outlines and proposes steps that can be introduced to promote preventive care. 


To ensure that their patients enjoy good health, practices should make preventive care a priority.

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Posted By Christine Shupe, Tuesday, December 26, 2017

Are empty blocks of time on the practice’s schedule causing you anxiety? Relax, there’s no need to get angsty, get proactive! Forward booking---when done right--- is an effective strategy for filling those appointment slots well in advance.


There are many advantages to implementing forward booking and that is why a number of service industries swear by it, including: dentists, stylists and even car dealers. They get it…there’s value in ensuring clients are locked in to an appointment. Not only are they more likely to return when an appointment is scheduled in advance, most importantly, as in the case of veterinary practices, compliance with the forward booked appointment will ensure the health and well- being of their pet.


However, to paraphrase a well-known axiom, “Forward booker beware.” There is a right way and a wrong way to forward book. A colleague shared the following story. She had purchased a car in May and the dealer wanted to schedule routine maintenance for December. She reluctantly agreed with a bit of a protest. Her remonstrations were typical …it’s too far in advance, I’ll forget.


The dealer assured her that a reminder would be sent in advance and she had the option to switch the date if it no longer worked. Lo and behold, December rolled around and she opened an email and found a service reminder---sent approximately 12 hours before the appointment. Havening forgotten about the appointment she could not rearrange her schedule to keep it so she cancelled. Weeks passed and the dealer did not call to reschedule. Eventually she initiated the call.


What started with good intentions fell off the rails. Bravo to the sales associate who got the appointment on the books. After that, the appointment went into a black hole. The reminder came too late and the dealer never followed-up to reschedule warrants two thumbs down!


The moral of the story is, if you are going to implement forward booking, take it on whole-heartedly so your clients see the value. Keep these suggestions in mind:

·        Get the buy in and commitment of your entire staff.

·        Train staff and provide them with a script for all types of responses.

·        When you book, follow through

·        Provide adequate time to remind clients

·        Contact clients by multiple platforms (email, text, phone)

·        If an appointment falls through and there is no follow-up by the client, be sure to contact the client and reschedule.


Periodic review, feedback from clients and follow-up will help to improve the protocol and ensure the procedures are relevant and applicable over time.


VHMA's Preventive Pet Healthcare: Your Guide to becoming a PRACTICE CHAMPION provides a step-by-step guide that helps managers establish a forward booking policy in their practice.  It's as easy as1...2...3...AND IT WORKS!


Don't just take our word for it.....check out these Forward Booking Success Stories.


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It’s Not Only What You Say, But How You Say It

Posted By Christine Shupe, Wednesday, November 8, 2017
Updated: Wednesday, November 29, 2017

Empathetic communication can improve client interactions


You say, “Forward book annual preventive healthcare visits,” Staff says, “Clients won’t do it!”


Staff says, “Surgery!” Clients say, “Not in the budget!”


Although I may be guilty of hyperbole, these examples do underscore a point. When managers attempt to implement new policies and procedures or deliver difficult news, how you communicate matters and can make the difference between the intended recipient embracing or disregarding the message.


You can avoid the uphill battle of convincing others of your position if you meet them at their level, this includes listening and understanding where they are emotionally. At the core of a successful exchange is empathy.


Empathy is defined as: The action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner


Incorporating empathy into communication---into both how you listen and respond ensures that what you say will resonate with the listener and increase the likelihood that they will be receptive to the message.


Get off to a good start!


The starting point for all good communications begins with making a connection with the other party. In a practice setting, when speaking to staff and/or clients, eye contact and focus are important. Communication doesn’t have to be formal to work. In fact, if it is too formal and prescribed, it can be off-putting. The key is to be natural and engaged.




Good listeners are active listeners. They hear what is said, formulate a response and respond appropriately. For example, a client who objects to scheduling a pet’s wellness visit a year in advance because he hasn’t even thought about what he’s having for dinner, might reconsider upon hearing, “And that’s the great thing about forward booking, it’s one less thing to worry about!”


Move that body!


All-in listeners know that their body language speaks volumes. Distracted movements distract the speaker. Body movements in moderation convey care and empathy. A head nod or a pat on the shoulder can enhance communications.


Legitimize the feeling


Never criticize, disparage or express outrage at a client’s response. Professionals can accomplish more by acknowledging feelings and then proposing solution. If a client were to say, “I’m planning a cruise. I can’t afford to pay for Dot’s dental surgery,” he may be more amenable to treatment if feelings are recognized before options are proposed.  For example, “I know how essential vacations are and I know that you care about Dot. The practice does offer financing options that may make it possible to address Dot’s dental issues and enjoy a vacation!” Positive statements express a desire to help, thereby reducing the number of roadblocks they may throw in your path.


Empathy is the ability to understand and share the feelings of another. Although most people are born with it, to provide excellent client communication and patient care it is helpful to ways to enhance and improve it.


To review specific example of how to communicate effectively with clients, patients and staff in a variety of situations, view the videos at






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Putting Out the Welcome Mat for Cats

Posted By Christine Shupe, Wednesday, October 25, 2017
Updated: Saturday, October 28, 2017

Although cats far outnumber dog as pets, cats average about 50 percent fewer veterinary visits per year. Veterinary professionals can ensure that their offices are welcoming to felines and their owners by incorporating cat friendly features into both the physical plan of the practice and the way in which care is delivered by eliminating barriers to veterinary visits and taking  steps to put the comfort and unique needs of the cat first.


Panic at the Clinic


Temperamentally, cats differ from dogs and these differences have an impact on why cat owners are less inclined to seek veterinary care. Even before the cat reaches the clinic, both owner and pet can be operating in full panic mode. Traveling to the office and setting foot in an unfamiliar environment can be alarming.  Upon arrival, stressors lurk at every turn: canines in the reception area, clumsy cat handling by staff and a noisy environment. 


But practices that are sensitive to cats and equipped to address their physical and emotional needs will not only increase veterinary visits, but ultimately improve the health and well-being of cats.


Is the Practice Purr-fectly appointed?


By focusing on these issues, clinics can create a more cat-centric environment:


1.    Support staff training and continuing education efforts that focus on feline handling techniques and special strategies for calming anxious cats. Cats and dogs are unique. Understanding and responding to these differences will equip staff to address to their needs and behaviors more effectively


2.    Take simple steps to create a physical environment that is all about the cat. Cordon off a small seating area with a bookcase or tall plants and obscure the cat’s view of the reception area where other pets congregate.


3.    Become the cat and examine the practice from a feline perspective. From reception area to the exam room, slink through the halls and take a critical view of whether the setting is inviting or off-putting to felines.


4.    Encourage at least one staff member to receive training or become knowledgeable about the complete cycle of feline life stage issues that require special care and attention. As with humans, health issues change as aging occurs.


Follow these suggestions and your practice will be the cat’s meow!


For feline-friendly practice tips and tools visit the Partners for Healthy Pets website.


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PRACTICE CHAMPIONS: Are You Harnessing the Power of Social Media to Connect People to Your Practice?

Posted By Christine Shupe, Monday, March 28, 2016

Ready, set connect! You’ve demonstrated your commitment to promoting preventive pet healthcare by leading the charge to make it a priority in the practice. The team is invested and protocols have been adopted. It’s time to connect the dots by ensuring that your efforts are reaching clients too. Preventive Pet Healthcare: Your guide to becoming a PRACTICE CHAMPION has devoted the final chapter to social media and strategies for using it as a powerful client education and marketing tool.


According to a world-wide internet user study conducted by The Washington Post, nearly half of all internet users are active Facebook users! The implication is clear: Facebook can provide practices with great opportunities for connecting with clients. What…your practice isn’t on Facebook? Don’t delay—sign up for a business Facebook page by going to


If your practice is on Facebook, congratulations! But to make sure Facebook is an asset to the practice, be sure that it is active and maintained regularly. Find out who administers the site and look for a pattern that indicates that information is posted with some regularity and that people are reading the posts and commenting.


If you are interested in creating more activity on Facebook, refer to pages 73-75 of the PRACTICE CHAMPION guide which presents tips for improving a practice’s Facebook traffic. The guide suggests liking other sites, sharing content, targeting posts and more.


Improving your practice’s Facebook presence can benefit even more from a plan. Some items that should be addressed in the plan include: the name of the staff person who will maintain Facebook, a list of possible content for the site that will appeal to clients and pre-written posts tied to topics that will cover the practice for 30-days. Because the level of enthusiasm is usually very high when a new endeavor get underway, having content available and a plan to refer to keeps the momentum going when people get busy and other commitments interfere. For more pointers, turn to page 76 in the guide.


As recommended throughout the guide, any plan is a collaborative process that should be reviewed by a supervisor or practice owner. It is also important review the plan with the entire team so they understand the goals they are working toward,


And while you are looking at the practice’s Facebook page, take time to revisit the practice’s website with a fresh perspective. What kind of impression does it make? Is the information current?  Pointers on conducting the review can be found in the guide on page 78.


As with all of the modules outlined in the guide, each chapter offers a comprehensive implementation strategy. Readers are encouraged to review the strategy and incorporate the steps that make sense to their specific situation.


Preventive Pet Healthcare: Your guide to becoming a PRACTICE CHAMPION is available to VHMA members for $49 and $89 for non-members.


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Posted By Christine Shupe, Sunday, February 28, 2016

You are an aspiring PRACTICE CHAMPION and an agent of change committed to transforming policies, procedures and attitudes to promote preventive pet healthcare. But how do you impact the behavior of clients? Preventive Pet Healthcare: Your guide to becoming a PRACTICE CHAMPION promotes a strategy for addressing this issue—forward booking, a best practice with the potential to increase client compliance and ultimately improve patient health.


Forward booking—the process of booking ALL patients’ next appointments before they leave the office—can increases the odds that patients visit the practice as required and receive appropriate services on schedule.


The forward booking conversation begins with the Practice Leadership Committee. Prep the group for the initial meeting with quality information such as current forward booking protocols, “Forward Booking Appointment: How to Fill Your Appointment Schedules,” downloaded from the Partners for Healthy Pets website, and the results of a survey detailing staff’s impressions of how the procedure is adhered to and implemented within the team.  Comprehensive background material will help to promote a productive meeting discussion.


Issue an invitation to Practice Leadership Committee (PLC) members via email. Be sure to include support documents. Page 64 of the guide provides an e-invite template.


This meeting is called to order

PHP’s “Forward Booking Appointment: How to Fill Your Appointment Schedules,” is the document that should guide the meeting. Several important decisions need to be made by the committee. The guide addresses these decisions on page 66. The practice’s Forward Booking Protocol should emerge from these decisions.


The five essential elements of the protocol are:

  1. A definition of forward booking
  2. A statement that underscore the practice’s commitment to holding itself accountable to implementing forward booking
  3. The agreed-upon forward booking intervals
  4. Definition of the forward booking reminder system
  5. Individual team member’s roles and responsibilities related to forward booking.

The specific elements are discussed in greater detail in the guide on page 67.


Share the draft protocol with the practice owner and circulate the protocol to staff once the owner gives final approval.


Once approved, page 69 outlines a strategy for introducing the protocol to the team. Page 69 is a good source of specific information about how to work with the team to ensure success.


Periodic review, follow-up and improvement to the protocol will ensure the procedures are relevant and applicable over time.


For a complete discussion and access to the tools that can facilitate forward booking in the practice, refer to Preventive Pet Healthcare: Your guide to becoming a PRACTICE CHAMPION (pages 61-70).


As with all of the modules outlined in the guide, each chapter offers a comprehensive implementation strategy. Readers are encouraged to review the strategy and incorporate the steps that make sense to their practices.

Preventive Pet Healthcare: Your guide to becoming a PRCTICE CHAMPION is available to VHMA members for $49. To order go to


Next Up…social media!

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