Online Case Submission

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**NO SAME DAY VALUE REQUESTS**

 

Please submit 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):
Patient history / chief complaint
Physical exam, blood results, radiographs findings (record any significant abnormalities)
Current Therapy
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.
DSU VET SERVICES, INC.

www.dsuvet.com

Phone: (305) 962-5207 Fax: (888) 719-1734
Phone: (305) 938-0590 Send me Email
DSU VET SERVICES, INC.

www.dsuvet.com

Phone: (305) 962-5207 Fax: (888) 719-1734
Phone: (305) 938-0590 Send me Email