Radiograph Submission Form Question Title * 1. Patient's name Question Title * 2. Owner's name (last, first) Question Title * 3. Birth date Question Title * 4. Species Canine Feline Question Title * 5. Breed Question Title * 6. Altered Yes No Question Title * 7. Weight(kg) Question Title * 8. Study Date Date / Time Date Question Title * 9. Study type HEAD NECK THORAX ABDOMEN PELVIS LONG BONE JOINT Question Title * 10. Patient's main presenting complaint(s) Question Title * 11. Relevant Recent Patient History (1-2 sentences) Question Title * 12. Clinician's Concerns Question Title * 13. Previously Diagnosed Patient Conditions Question Title * 14. Patient's Current Medications Question Title * 15. Create a link to your DICOM images https://www.dicomlibrary.com/ and paste it below!*FOR DETAILED INSTRUCTIONS*, CLICK HERE: HOW TO UPLOAD YOUR DICOM LINK Done