Online Case Submission

SCHEDULE ANNOUNCEMENTS

DSU WILL BE CLOSED (MAY 27TH – MAY 31ST)

—Updated Price List March 1st—

 

 ***PLEASE CALL / EMAIL FOR AVAILABILITY BEFORE SENDING CASES, THANK YOU***

DO NOT SUBMIT WITHOUT DSU APPROVAL, THANK YOU 

 

 

ONLINE FORM INFO DIRECTLY AFFECTS SPECIALIST REPORTS

PLEASE INCLUDE SPECIFIC DETAILED INFO ON THE FORM

send most recent Blood-work / X-Rays

Fax: 888-719-1734 / office@dsuvet.com

Hospital Information
Ultrasound Date* (This is the date you wish the ultrasound to be performed)
Hospital*
Veterinarian*
Phone*
Fax*
Email*
Patient Information
PET LAST NAME*
**PET NAME***
Species*
Breed*
Date of Birth*
Weight (lbs)*
Gender:
Intact
Ultrasound study
Other (please specify):
Ultrasound Category     (See Ultrasound Packages)
Other (please specify):
Reason for visit? Main complaint?
Most remarkable PHYSICAL EXAM findings(record any significant abnormalities)
Current Therapy(Please specify dosages)
Attachments
Other (please specify):
Please write the text exactly as shown on the image below:
captcha
  • To submit any paper work (medical notes, lab work...)
  • To send x-rays, photos and images.

send to: office@dsuvet.com

If your form is complete please click:
Click here to download the form and fill it offline.