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Outpatient Ultrasound
Exceptional People Providing Excellent Care
Outpatient Ultrasound
Clinic Name
*
Primary Veterinarian's Name
*
Pet Owner's Name
*
Patient Name
*
Best Phone Number To Reach You
*
Upon arrival, the client and pet will be greeted by the CVETS radiologist's assistant. If the pet appears to require medical attention, the radiologist will contact you to determine if the pet should be triaged by a CVETS emergency doctor or referred back to your practice for further evaluation. If the patient appears in critical condition, the radiologist will have the pet evaluated by a CVETS emergency doctor immediately. By submitting this form, you have agreed to these terms.
Pet Owner's Phone
*
Pet's Age, Sex and Breed
*
Clinically Relevant History
*
Working and Prior Diagnoses
*
Type of Ultrasound
*
Abdominal
Non-Cardiac Thoracic
Neck
If other Please explain
Other Type Explanation
*
What are your main clinical questions for the radiologist?
*
Do you anticipate sedation being needed to complete the exam?
Yes
No
Explanation
*
Are there any contraindication for sedation?
*
Yes
No
N/A
Have you consulted with another CVETS veterinarian about this case?
*
Yes
No
CVETS Veterinarian Name
*
Emergency
Surgery
Specialties
Internal Medicine
Oncology
Neurology
Ophthalmology
Dentistry
Dermatology
Radiology
Anesthesia
Pet Owners
Why CVETS?
Care Credit Bill Pay
Pre-registration
Financial
For Vets
Online Referral
CVETS Connects
Teleradiology
Ultrasound
Referral Documents
More
Leadership
Meet The Doctors
The CVETS Team
Facility
Join Our Team
CVETS Blog
Contact Us
Call Now: 803-995-8913
Get Directions
Online Payment
CVETS Connects
Online Referral
Pet Registration