Minnesota Urolith Analysis Submission Form

To submit the form, send the completed and signed form and the urolith sample to the specified address: Hill's Pet Nutrition, PO Box 3964, Sydney NSW 2001. For queries, contact 1800 800 733. Ensure the sample is washed, dry, and appropriately labeled. Do not send urine samples or sediment. Use unbreakable containers and follow the packaging instructions carefully. Registered post is recommended to ensure delivery.

This form is valid for submission throughout 2024 and 2025. Check for any updated versions on the Minnesota Urolith Center website before submission.

The purpose of this form is to provide a standardized method for submitting urolith samples to the Minnesota Urolith Center for quantitative analysis. Veterinary clinics, surgeons, and pet owners can use this form to ensure the accurate and consistent submission of samples, facilitating the center's analysis and diagnosis services. The form includes fields for clinic and patient information, details about the urolith sample, dietary history, and urinalysis results, ensuring comprehensive data collection for precise analysis and diagnosis. This form helps streamline the submission process, improve sample handling, and ensure the integrity and reliability of the sample data received by the Minnesota Urolith Center.

• 1. CLINIC INFORMATION: Includes the date, veterinary surgeon's name, clinic name, address, telephone, and email.
• 2. CLIENT AND PATIENT INFORMATION: Includes owner's name, animal's name, species, breed, age, gender, and source of urolith.
• 3. Sample retrieval method: Specifies the method used to retrieve the urolith sample.
• 4. Dietary history: Details the diet fed to the animal prior to urolith detection.
• 5. Urinalysis and urinary case history: Includes information about previous uroliths, urine culture results, and antibiotic history.
• 6. Current body weight: Specifies the current body weight status of the animal.
• 7. IMPORTANT INSTRUCTIONS: Guidelines for sending the urolith sample, including packaging and addressing instructions.

Failure to submit this form may cause delays or issues with the analysis process.

• Incomplete Data: Lack of detailed information can lead to inaccurate analysis.
• Sample Handling Issues: Improper packaging or labeling may result in sample loss or contamination.

• 1. Veterinary Clinics: For the submission of patient urolith samples to the analysis center.
• 2. Pet Owners: To facilitate the analysis of their pet's urolith samples.
• 3. Researchers: For collecting and submitting data for clinical studies.
• 4. Animal Hospitals: To ensure accurate diagnosis and treatment planning based on urolith analysis.
• 5. Specialist Surgeons: For detailed urolith analysis to support surgical decisions.