CATS TEST REQUEST FORM

Go back

Instructions:
- Fill out the form in all its parts
- After filling out the form complete with all its data, press SEND at the bottom of the page before printing.
- At this point, the form must be:
1. Printed
2. Stamped
3. Signed by the VETERINARY
4. Signed by the OWNER
5. Posted attached to the sample and to the copy of payment.
- The report is mailed to the owner

 

INFORMATIONS
TEST(S) REQUESTED
Hereditary patology
DNA sample storage
 Genetic Identification *SUSPENDED
 Parentage determination *SUSPENDED
Polycystik Kidney Disease PKD *
Blood type *
Hypertrophic Cardiomyopaty HCM*
Spinal Muscolar Atrophy  SMA *
 GLICOGENOSI IV   SUSPENDED
PK DEFICIENCY
KARYOTYPING Test  (Blood in 24/48 Hours)
Coat Color Tests
 DILUTE COAT COLOR  SUSPENDED


Information: "Part of the services, under the responsibility of Vetogene Srl, may be entrusted to external testing laboratories that have successfully passed the
CT-CG ISAG and / or meeting the requirements

ISO 9001 or ISO 17025 in force. "

"THE TIMES OF TEST RESULTS ARE SUBJECT DELAYS FOR TECHNICAL PROBLEMS RELATED TO THE TYPE AND

  STORAGE OF BLOOD - RECEIVED DNA "

  Price
 
 

 € 0,00 Totale

SAMPLE
Blood
Cytobrush
Cotton fioc 
Other
 
 
 
*The price is inclusive of DNA sample storage.
Date of sampling
City
Veterinary name
Veterinary E-mail
Note
OWNER INFORMATIONS
Name
Adress
City / Province
Postal code / Country
Phone
E-mail
INVOICE DATA  (if are different from owner )
Name
Address


Consent to the processing of personal data      (required)
By sending this form I consent to the processing of data for the request in accordance with our privacy policy (mandatory acceptance). Explicit consent according to the GDPR, General Data Protection Regulation - EU Regulation 2016/679.
 
CAT IDENTIFICATION
Registered Name
Breed
Sex
Birthdate
Castrated
Mantle
Registration number
Chip
FAMILY CAT INFORMATIONS
Registered name of Sire
Registered number of Sire
Registered name of Dam
Registered number of Dam