We are pleased to accept outpatient referrals for X-Ray and Ultrasound.
Practice name *
Referring Vet *
Phone number *
Email *
Client name *
Contact number *
Patient name *
Species *
Breed *
Gender * Male neuteredMale intactFemale spayedFemale intact
Age / Date of birth *
Has the patient evidence of
Heart disease
If so, please provide us with short history / main complaints
Renal disease
Known adverse reactions / allergies
Recent surgeries
Presence of metallic implants
Pregnancy
Endocrine Disease
Coagulopathy
Neoplasia
Epilepsy
Difficult airway or aspiration risk
Other
Location to be scanned (select one or more of the following). Note: we will only image the areas requested.
HeadThoraxAbdomenPelvis/hipsSpine C1-T2Spine T2-tailShoulderElbowCarpus/footStifleTarsus/foot
Ultrasound location to be scanned (select one or more of the following)
ThoraxEchocardiogramAbdominalOther
Report turnaround
Standard 1-3 daysPriority 24 hoursUrgent 4 hours
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