I hereby authorise the Centre Hospitalier Universitaire Vétérinaire to copy the following file:
Name of the animal (obligatory)
Owner name (obligatory)
Email adress (obligatory)
Phone number (obligatory)
Reason for obtaining copy: (obligatory)
I subsequently accept to pay the following fees:
Patient file (51$ + tx)X-rays on CD (18,49$ +tx)
The price is subject to change if the file is very large. In this case, you will be contacted directly to be notified.
Sending the copy by
Address or fax number:
We will contact you soon for the payment and confirm your request.