To request a consultation and/or mobile procedures, please fill out the patient case summary form below. If you have any questions regarding this form, please contact Dr. Nancy Treadwell, Shreveport Veterinary Internal Medicine at the phone/fax numbers below or email us at

Contact SVIM at:318-224-2677
Send a Fax:1+ 318-301-6720

Mobile procedures/consults are at your hospital or practice location.

Requesting Veterinarian

Please provide all relevant contact information so that we may get in touch with you.
First and Last Name


Pet Owner / Caregiver
First and Last Name

Patient Information

Please check all that apply.

Medical records, x-rays and images relative to your patient case summary may be emailed to