Return the Samples
If time allows, let the brush air dry in a clean place for a few hours to overnight. Carefully replace the brush back into the package. Use a piece of tape to help keep the package closed if necessary, but do not seal tightly.

Send the sample brushes and payment (check, money order, or credit card) by regular mail. Be sure to include your contact information.

Please complete the following on your computer and then print using the Print Feature of your Web browser OR print first and complete the form by hand. If the form is handwritten, PLEASE PRINT LEGIBLY.   *required fields

This is NOT an online submission form. If you are requesting a test kit you may submit your request for a test kit online

Dog Name

Dog Breed

Name of Person Submitting the Sample

Address (of credit card holder) *

City, State, Zip Code *

Phone Number *

FAX Number

e-mail

If you are paying by credit card please select the card type:

Visa        MasterCard

Credit Card Number

Expiration Date

VCODE  (The last 3 digits of the long number on the back of the card

Pricing

For 1-4 tests included in a single shipment the cost is $60 US Dollars per test
For 5 or more tests included in a single shipment a 15% discount will be applied for a cost of $51 US Dollars per test.

We can accept payment in US Dollars by check, money order, or credit card (MasterCard or Visa. Please do not send cash.

Test results will generally be available within two weeks.  Please indicate how would you like to be notified of the test results

     Regular Mail  E-Mail   FAX

You will then know if your dog has the mutation and if your dog is likely to have problems when given drugs on the Problem Drugs List.

Send the labeled brushes, contact information and payment to:

Veterinary Clinical Pharmacology Laboratory
PO Box 609
Pullman, WA 99163-0609
(Phone/FAX 509-335-3745)

VCPL@vetmed.wsu.edu

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