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Radiation Oncology Consult Form

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

This information will be routed to the Service that you request. We will do our best to respond as soon as possible. This will generally be within 48 hrs of submission. If you have not had a response within that time, please call the Service directly. Because consults are often addressed at the end of the day, please provide contact information for the late evening, if possible.

What is your preferred contact method?(Required)

Veterinarian Contact Information

Owner Contact Information

Name of the owner
Address

Information about the patient

Has this patient ever been seen by any service at NC State Veterinary Hospital?
Patient/Pet Name
Species
MM slash DD slash YYYY
Gender
Drop files here or
Max. file size: 195 MB.