Case Submission Form
2015 Western Conference of Veterinary Diagnostic Pathologists
Avian Pathology
We are hoping to receive a variety of acute or early processes with a variety of genetic, toxic,
degenerative and infectious inciting causes in birds (poultry, pet, wildlife and other).
Please complete and forward this form, electronically and as a hard copy, for each case you submit.
Cases can be from current or archived material. One block per case is preferred.
Please submit cases at your earliest convenience and no later than May 1, 2015.
Contributor:
Affiliation:
E-mail address:
Block or Case #:
Morphological diagnosis:
Ancillary diagnostics:
Etiology:
Case Introduction (as you would like it to appear in the case book; animal signalment, clinical history,
± gross necropsy findings):
For each case, please submit:
Send everything to:
 - this case submission form
 - a block
 - one H&E section of the block
 - a specially stained section of the block (if one is
essential for the proper interpretation of the case)
Dr. Jenny Fricke, WCVDP
WCVM – Vet Path
52 Campus Drive
Saskatoon, SK S7N 5B4 CANADA
Email: jenny.fricke@usask.ca
For Customs purposes, indicate that the contents of your parcel have no commercial value and are
for educational purposes only. A nominal value of $10.00 is suggested.