• Do not fill this form out if you're a solicitor.
  • ADVANCED IMAGING REQUEST

    This form should be submitted at least 24 hours in advance of the date that you are requesting. All imaging requests require recent CBC/Chem blood work (within the last month). MRI requests also require 3 view chest radiographs within the last 3 months due to the length of anesthesia required. Incomplete packages (i.e. no blood work or chest radiographs) will not be reviewed until all information is provided. 

    Specifics of your request such as questions about positioning and scan time can be directed to the Imaging Veterinarian or the Technologist on duty. We will do our best to accommodate your requests, but same-day scans may not be possible due to pre-existing case load. We will reach out to the client to schedule once we have received the request and all necessary medical records (blood work and/or chest radiographs).

    This is an outpatient imaging service only. We are unable to accommodate requests for additional diagnostic procedures at this time.

  • Select all that apply.
  • This will aid the radiologist when reading the scan.
  • For STAT reads, radiologist response is expected within 4-6 hours. All other requests are returned within 24-48 hours.
  • Requesting Veterinarian Information

  • Radiology report will be emailed within 1 business day.
  • Patient Information

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    Imaging requests will not be reviewed or scheduled until all necessary information is received. Please attached any blood work or radiographs to this request form.
  • This field is for validation purposes and should be left unchanged.