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College of Veterinary Medicine 
Veterinary Hospital

Oncology Consult Form

This service is for veterinarians only – clients seeking medical information should contact their regular veterinarian for assistance.

We do our best to respond to all consult requests in a timely manner. The need to balance teaching and ongoing care of our active cases with the high volume of consult requests may delay our response.

In general we are unable to review extensive medical records or images. Imaging studies (in digital format) can be sent directly to the Radiology Service for interpretation.

For emergent consultations, please feel free to contact our emergency department at 919-513-6911 to speak with an emergency clinician immediately.

Veterinarian Contact Information

What is your preferred contact method?(Required)

Owner Contact Information

Name of the owner(Required)
Address

Information about the patient

Has this patient ever been seen by any service at NC State Veterinary Hospital?
Patient/Pet Name(Required)
Species(Required)
MM slash DD slash YYYY
Gender

Diagnosis: please fax biopsy report to 919-513-6669 or email to NCStateOncology@ncsu.edu (recommendations cannot be made without a biopsy confirmed diagnosis)

Is there measurable gross tumor still present?
Diagnostic test performed and attached results (Please do not fax entire medical record)
MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY
Drop files here or
Max. file size: 195 MB.

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