Canine Tumor Submission Form
At this time, K9-ACV is for canine species only.
Veterinarian Name
First Name
Last Name
Clinic Name
Clinic Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pet Information
Dog's Name
Species
Please Select
Canine
Feline
Equine
Other
Dog's Age
Dog's Weight
Breed
Pet Owner's Name
First Name
Last Name
Contact Phone Number
Please enter a valid phone number.
Pet Owner's Email
Email is required for paperless invoicing
Information for K9-ACV: ALL FIELDS REQUIRED
Amount of tumor submitted (g)
Tissue Type/Suspected Cancer
Will you be using Ardent's Histopathology via Vdx Labs?
Yes
No
Payment Information
Submit
Should be Empty: