New Client Form - Wisconsin Veterinary Diagnostic Laboratory

New Client Information

You can expect an email with instructions for access to our Client Portal within 3 business days of submission of this form. If you have questions or do not receive instructions, please contact billing@wvdl.wisc.edu. You may submit samples without Client Portal Access. The client (DVM and/or veterinary clinic) is responsible for the submission and test charges.

Phone

This field is for validation purposes and should be left unchanged.

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Clinic Information(Required)

Full Clinic name

Clinic Address

Street Address Address Line 2 City State ZIP Code

Clinic Phone number(Required)

Clinic Email Address – Invoices(Required)

Clinic Email Address – Test Results(Required)

Clinic Test Results FAX number (Optional)

Please email billing@wvdl.wisc.edu if you would like results sent to Fax automatically.

Additional reporting emails/portal accounts

Each doctor may have their own email in addition to the clinic email for result reporting. We will send a portal invite to every email listed here.

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