Access Veterinary Care | JBOS Diagnostic Request

Your Name:

Animal Name + Unique six-digit number

Please provide a six-digit number to simplify tracking in our system; too many Oreos and Muffins :)

Diagnostics Requested:

Species

Dog

Cat

Sex:

Male, Intact

Male, Neutered

Female, Intact

Female, Spayed

Age

Reason for diagnostics

Screening, outwardly healthy

Health Concern

Describe the current health concerns in detail

Pick one:

We will drop off the necessary samples.

We need a tech appointment to obtain the samples.

For bloodwork: provide a red top serum separator and purple top tube. The red top should be allowed to clot for 20-30m and centrifuged immediately after.
For urinalysis: provide 2-3 mls in a white top tube.
Label all tubes with name and 6-digit number. Any unlabeled tubes will be discarded.

Requested BW:

Basic Screen (~$50)

Vet Screen/CBC/Urinalysis (Recc for health concerns, ~$150)

DVM discretion based on history

Call to discuss (may delay by 24-48h)

OtherOther

After submitting, please call 812 590-3081 to setup the tech appointment (approx $20). If you have any concerns about aggression towards other animals or humans, let our staff know. Our staff’s safety comes first and we will not work with human-aggressive animals for this purpose; animal-aggression is usually manageable if we know about it.

This request has been approved by Sarah Green, or another authorized JBOS representative.

Yes

No

All submissions must be approved for payment by Sarah Green or a representative authorized to approve on her behalf.