Cardiology Study Interest Form

Client Information

Name(Required)

First Last

Phone(Required)

Email(Required)

Contact Preference(Required)

Patient Information

Has your pet previously participted in a clinical study?(Required)

Is your pet currently established as a patient with the UF Veterinary Hospital?(Required)

Pet's Name(Required)

Pet's Sex(Required)

Pet's Age(Required)

Pet's Weight (lbs)(Required)

Species(Required)

Breed(Required)

Study Information

Study of Interest(Required)

View Descriptions here

Gene Therapy for Dilated Cardiomyopathy in Dobermans

Tolerability and clinical efficacy of oral potassium chloride for treatment of hypochloremia in canine congestive heart failure

Fibroblast cell isolation and expansion and iPSC derivation in purebred Maine Coon and Ragdoll cats

Does your pet have a confirmed diagnosis for the study of interest?(Required)

For our taurine and acetazolamide studies, does your pet have a confirmed diagnosis of Congestive Heart Failure (CHF) (e.g. Stage C and receiving furosemide or torsemide)?(Required)

Please list all Cardiology-related diseases your pet has been diagnosed with (past and present)(Required)

Has your pet had any cardiology-related diagnostics (E.g. an Echocardiogram)(Required)

If yes, please list them. If no, just write N/A(Required)

Please list all other diseases your pet has been diagnosed with (past and present)(Required)

Please list any medications and supplements that your pet is currently receiving(Required)

Primary Care Veterinarian Information

Name of your primary care veterinarian(Required)

First Last

Name of your primary care veterinary clinic(Required)

Has your veterinarian sent over your pet's medical records?(Required)

CAPTCHA

Client Information

Patient Information

Study Information

Primary Care Veterinarian Information

IFAS

Scholars Program

Our Hospitals