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College of Veterinary Medicine 
Veterinary Hospital

Small Animal Sports Medicine and Rehabilitation Consult Form

You are submitting a Consult to the Small Animal Sports Medicine and Rehabilitation Service. We will do our best to respond as soon as possible. This will generally be within 48-72 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(Required)
MM slash DD slash YYYY
Gender

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