Survey - VIN RMUW-19 LSA StudyENROLLMENT FORM

You are enrolling a patient into the VIN RMUW-19 LSA study. You will be asked to assign a patient ID during the enrollment (usually the pet name).

You will be contacted by the study coordinators after enrolling a patient. They will determine the eligibility of the patient.

Please note the enrollment criteria for RMUW-19. In brief, dogs have to have Stage III or Stage IV LSA that has been diagnosed and staged as completely as possible. If you patient does not fulfill these criteria, please consider enrollment at another time.

Thank you for your participation.

IMPORTANT: Enrollment of a patient into the VIN RMUW-19 LSA study assumes that the client consent form has been completed by the client. You can download the Client Consent Form here:
Client Consent Form

Please mail the completed consent form to the study coordinators (address on bottom of form).

Click on the Continue button to start the Enrollment Form.