Yu of Guelph Veterinary Dermatology
519-821-SKIN (7546)

Dermatology Consultation Form

Consult by Phone $120.00 CDN


Client Information











Veterinarian Information












Dermatology Consult

Referring VETERINARIAN to complete the following areas:



Patient Information:










Attached Photos:


Treatments that have been used:

Date Treatment or Diet tried Response

Payment




Fees

Phone consult and follow-up

$135.60 ($120 + HST)


DISCLAIMER: Please remember that while great care is taken in the preparation of consultations, recommendations made are based only on the material provided. This may not truly reflect the nature of the case and may not be appropriate to the individual patient. Veterinarians are reminded that the case remains under their care and responsibility, and our recommendations represent only suggestions. To minimize risks of transcription error, all suggested drugs and doses should be checked, using standard texts and formularies.