1. Please provide the following contact information:

    Name
    Title
    Clinic
    Phone
    FAX
    E-mail

  2. Please provide the following animal information:

    Name

  3. Animal's Age:

    Age

  4. Animal's Sex

    Sex

  5. Breed of Animal:

    Breed

  6. Animal is a:

    Dog
     Cat

  7. Allergy testing performed at Spectrum Labs:

    Yes
     No

  8. Information about lab testing:

    Lab Number

  9. Enter the date of testing:

    -- mm/dd/yy

  10. In the case of a DOG - eliminate the following foods from the diet (Positive or Borderline):

    Beef            
Rabbit         
Chicken         
Pork          
Venison         
Eggs            
Milk            

Soybean       
Corn            
Wheat           
Lamb            
Rice          
Turkey          
Sorghum         
Oatmeal         
Barley        
White Potatoes  
Brewers Yeast   
Kelp            
Tomato Pomace 
Fish Mix        
Carrot          
Peas            
Duck

  11. In the case of a CAT - eliminate the following foods from the diet (Positive or Borderline):

    Beef                        
     Rabbit
     Chicken
     Pork
     Venison
     Eggs
     Seafood/Fish Mix
     Soybean
     Corn
     Wheat
     Lamb
     Rice
     Turkey
     Sorghum
     Oatmeal
     Barley
     White Potatoes
     Brewers Yeast
     Milk
     Tomato Pomace
     Flax Seed Meal
     Alfalfa
     Duck Tuna