DICOM Upload - Fracture – reduction system

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Surgeon's Details

First Name:*

Last Name:*

Practice Name:*

Address Line 1:*

Address Line 2:

Town:

Post Code:*

Email:*

Phone Number:

Phone Number (Out of hours):

Preferred method of contact:* Please choose Email Phone Number Phone Number (Out of hours)

Patient's Details

Pet Name:*

Age:*

Client Surname:*

Weight:*

Species:* Please choose Dog Cat Other

Breed:*

Case Details

Priority: Please choose Routine Urgent

These cases are assumed to be urgent - please call us in addition to completing this form to discuss your exact requirements:
Email: info@vet3d.co.uk
Telephone: +44 (0)1676 534927

Which bone is fractured?*:

Do you require guides for - * Please choose MIPO ORIF

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Accepted files: .tar, .rar, .tar.gz, .7z, .zip

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