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24 HOUR EMERGENCY
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Community Blood Bank
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Home
About Us
Mission Statement
Meet Our Team
Careers
Services
24-Hour Emergency & Critical Care
Community Blood Bank
Cardiology
Dentistry
Dermatology
Exotic Animals
Imaging Center – CT & MRI
Internal Medicine
Neurology
Oncology
Pet Transport Service
Rehabilitation
Surgery
Equine
For Pet Owners
Request Information
Events
Pet Transport Service
Tour
New Patients
The UVS Cares Foundation
For Veterinarians
Patient Referrals
rDVM Portal
Events & C.E.
Pet Transport Service
News & Events
Calendar
Community Partners
The UVS Cares Foundation
Testimonials
Blog
Contact
Tour
Review Us
Search for:
Request Information
Home
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Request Information
Request Information
University Veterinary Specialists
2018-06-15T15:56:38+00:00
Please use this form to send us an email. Please do not use this form for urgent matters.
We are open 24/7; if you require immediate attention, or have an emergency, call us:
724-717-2273
Client Name
*
First
Last
Patient Name
*
First
Patient Species
*
Dog
Cat
Horse
Exotic
If 'Exotic' please specify in 'Notes' section
Department
*
Surgery
Emergency
Dermatology
Internal Medicine
Exotics
Oncology
Reproduction
Equine Dentist
Canine Rehabilitation
Behavior
Small Animal Dentistry
Other
If 'Other' please include comments in the 'Notes' section.
Preferred Time of Day
*
Morning
Afternoon
First Available
Phone
*
Alternate Phone
Email
*
Best Way to Contact You
*
Phone
Alternative Phone
Email
Notes